Morphofunctional markers to assess disease-related pediatric malnutrition at admission and their association with length of hospital stay.

BACKGROUND

Disease-related malnutrition (DRM) occurs due to energy imbalance caused by increased catabolism, decreased appetite, or increased energy losses. In hospitalized patients, the presence of DRM can increase morbidity, disability, and mortality, as well as delay recovery from the disease. Therefore, identifying accurate nutritional markers associated with length of stay (LOS) in pediatric patients is important.

OBJECTIVE

The objective of this study was to explore the association between morphofunctional markers used to evaluate DRM upon hospital admission and LOS in pediatric patients.

METHODS

Exploratory, single-center prospective cohort study was performed in a single center study with patients evaluated within 24-48 h of a third level pediatric hospital. Upon hospital admission, nutritional risk was determinate risk nutritional status screening, anthropometric measurements were made such as weight, height, mid-upper arm circumference (MUAC), calf circumference (CC); body composition with bioelectrical impedance analysis (BIA) and handgrip strength (HGS) was carried out. DRM was diagnosed based on body mass index-for-age z-score (BMIz) < -2 standard deviations (SD).

RESULTS

A total of 139 pediatric patients (mean age 12.1 ± 3.3 years) were included; DRM was present in 15.8%. Among patients with DRM, those who concomitantly presented low phase angle (PhA), low CC, and low HGS had a significantly longer median LOS [15 (5-27) days] than those with values above the established cutoff points [(8 (5-13) days], (p = 0.029).

CONCLUSION

In pediatric patients with DRM, lower levels of morphofunctional markers (PhA, HGS, and CC) at hospital admission were associated with prolonged hospital stay. These findings, derived from a Mexican pediatric population, warrant external validation in larger and more diverse cohorts.