Turkish archives of pediatrics · 2025
Micronutrient Deficiencies and Their Impact on Hospitalization Duration in Pediatric Palliative Care: A Retrospective Cohort Study.
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Keskin Doğukan Mustafa, Çeri Ayhan
Аннотация
OBJECTIVE: To evaluate the frequency of micronutrient deficiencies and assess their association with the duration of hospital stay in pediatric palliative care (PPC) patients.
MATERIALS AND METHODS: This retrospective study analyzed 81 children hospitalized in the PPC unit of Dr. Ali Kemal Belviranlı Obstetrics and Gynecology Hospital. Data included demographics, clinical characteristics, nutritional status, and serum levels of ferritin, vitamin D, vitamin B12, and folate. Hospital stay was categorized as short (≤5 days) or long (>5 days) based on median duration. Clinical and laboratory parameters were compared between groups, and multivariate logistic regression was used to identify independent predictors of prolonged hospitalization.
RESULTS: The median age was 51 months, and 58.02% of the patients were male. Neurological or neuromuscular conditions were the most common underlying diagnoses (66.67%). At least 1 micronutrient deficiency was observed in 45.68% of patients. The frequency of folate, ferritin, vitamin D, and vitamin B12 deficiencies was 9.88%, 12.35%, 7.41%, and 1.23%, respectively. Patients with prolonged hospital stays had significantly higher ferritin levels (127.5 vs. 43.8 ng/ mL; P = .001) and lower vitamin D levels (26.68 ± 9.70 vs. 31.77 ± 11.36 ng/mL; P = .033). In multivariate analysis, nutritional support via nasogastric or gastrostomy tube (odds ratio [OR]: 4.931; 95% confidence interval [CI]: 1.310-17.385; P = .018) and lower vitamin D levels (OR: 0.937; 95% CI: 0.896-0.991; P = .020) were independently associated with prolonged hospitalization.
CONCLUSION: Lower vitamin D levels and enteral nutrition support are linked to prolonged hospitalizations in PPC patients. Routine screening and timely interventions may help improve outcomes.
MATERIALS AND METHODS: This retrospective study analyzed 81 children hospitalized in the PPC unit of Dr. Ali Kemal Belviranlı Obstetrics and Gynecology Hospital. Data included demographics, clinical characteristics, nutritional status, and serum levels of ferritin, vitamin D, vitamin B12, and folate. Hospital stay was categorized as short (≤5 days) or long (>5 days) based on median duration. Clinical and laboratory parameters were compared between groups, and multivariate logistic regression was used to identify independent predictors of prolonged hospitalization.
RESULTS: The median age was 51 months, and 58.02% of the patients were male. Neurological or neuromuscular conditions were the most common underlying diagnoses (66.67%). At least 1 micronutrient deficiency was observed in 45.68% of patients. The frequency of folate, ferritin, vitamin D, and vitamin B12 deficiencies was 9.88%, 12.35%, 7.41%, and 1.23%, respectively. Patients with prolonged hospital stays had significantly higher ferritin levels (127.5 vs. 43.8 ng/ mL; P = .001) and lower vitamin D levels (26.68 ± 9.70 vs. 31.77 ± 11.36 ng/mL; P = .033). In multivariate analysis, nutritional support via nasogastric or gastrostomy tube (odds ratio [OR]: 4.931; 95% confidence interval [CI]: 1.310-17.385; P = .018) and lower vitamin D levels (OR: 0.937; 95% CI: 0.896-0.991; P = .020) were independently associated with prolonged hospitalization.
CONCLUSION: Lower vitamin D levels and enteral nutrition support are linked to prolonged hospitalizations in PPC patients. Routine screening and timely interventions may help improve outcomes.