Prevalence of malnutrition in pediatric hospital patients and a method to evaluate the nutrition risk in hospitalized patients

Objective: In this study, it was aimed to evaluate the nutritional status of children at hospital admission and discharge. And to investigate the effects of hospitalization on the weight loss of children, to estimate the risk of malnutrition during hospitalization. Materials and methods: 500 inpatients in Akdeniz University Pediatric Clinic of Medical Faculty between October 2012-August 2014, aged between 1 month-18 years, whose length of stay in hospital more than 3 days were included to our study. During the admission and discharge anthropometric measurements were taken and malnutrition levels were determined for each patient. Scores for sex, age, length of hospitalization, presence or absence of pain, dyspnea, high body temperature, vomiting and diarrhea recorded on follow up forms. Results: According to Gomez classification, at the time of admission, 139 (27,8%) of the cases had mild, 80 (16%) had moderate, 39 (7,8%) had severe malnutrition and there was no malnutrition in 242 (48,4%) patients. According to Waterlow classification 19,8% (n=99) was defined as acute malnutrition, 19,8% (n=99) as chronic and 20,2% (n=101) as acute-chronic malnutrition. During hospitalization, 183 (36,6%) of the cases didn't lose weight and 317 (63,4%) lost weight. According to Gomez and Waterlow classification, as the poor nutritional status increased, the patients were hospitalized longer (p=<0,001). According to Gomez classification 60 (12%) and to WHO BMI classification 77 (15,4%) of the cases' nutritional status got worse at the time of discharge. Anthropometric measurements, symptoms (pain, dyspnea, high body temprature, vomiting and diarrhea) were evaluated at admission. Pathology was classified as mild (grade 1), moderate (grade 2) or severe (grade 3). We accepted the endpoint criterions as a weight loss of >2% and >4% of the reference weight measured at admission. Conclusions: The rate of malnutrition is substantially high in patients hospitalized because of different reasons. The rate of patients with no marked malnutrition at the time of hospitalization who develop malnutrition during hospitalization is also substantially high. As a result of our study, we designed two different models to identify patients at risk of malnutrition during hospitalization. It should be accepted that interrogation of nutrition is a part of normal examination to increase awareness on this issue