Abstract
Objective: Many scoring systems are used in determining the mortality in child intensive care units and protein energy malnutrition is not included in the evaluation criteria. Because of this, protein energy malnutrition is often not well assessed and can lead to increased mortality and morbidity. In our study, we aimed to evaluate the incidence of protein energy malnutrition and its effect on mortality and morbidity during the first admission.
Material and Methods: Patients admitted to the pediatric intensive care unit and hospitalized for at least 24 hours were examined prospectively. Demographic data, age, gender, the incidence and duration of mechanical ventilation, etiology and duration of admission to intensive care unit, PRISM III and PELOD scores, and mortality rates were evaluated. According to National Neyzi Standards (2008) for malnutrition, weight by age, weight by height and height by age percentages and z-scores were calculated, and values <-2 SD were defined as protein energy malnutrition.
Results: One hundred twenty-six patients were analyzed. Fifty-two (41.3%) patients had malnutrition. Median age was 12 months (7-30 months) and was significantly higher in patients with protein energy malnutrition (p=0.001). PRISM score was 17 and PELOD score was 20 , which was statistically significant (p=0.01, p<0.001). Respiratory insufficiency (29%) was the most frequent cause of hospitalization in patients with protein energy malnutrition. The
Keywords: Child, Critically ill, Mortality, Malnutrition
References
- Lochs H, Allison SP, Meier R, Pirlich M, Kondrup J, Schneider S, et al. Introductory to the ESPEN guidelines on enteral nutrition: Terminology, definitions and general topics. Clin Nutr 2006;25:180- 6.
- Bayır H, Yıldız İ, Erkuran MK, Koçoğlu H. Yoğun bakım hastasında malnütrisyon. Abant Med J 2015;4:420-7.
- Peterson SJ, Sheean PM, Braunscweig CL. Orally fed patients are at high risk of calorie and protein deficit in the ICU. Current Opinion in Clinical Nutrition&Metabolic Care 2011;14:182-5.
- Nangalu R, Pooni PA, Bhargav S, Bains HS. Impact of malnutrition on pediatric risk of mortality score and outcome in pediatric intensive care unit. Indian J Crit Care Med 2016;20:385-90.
- Quirk J. Malnutrition in critically ill patients in intensive care unit. Br J Nurs 2000;24:537-41.
- Güleç SG, Urgancı N, Polat G, Hatipoğlu N. Hastanede yatan üç yaş altı çocuklarda PEM durumunun değerlendirilmesi. Ş.E.E.A.H Tıp Bülteni 2011;45:124-9.
- El Halal MG, Barbieri E, Filho RM, Trotta Ede A, Carvalho PR. Admission source and mortality in a pediatric intensive care unit. Indian J Crit Care Med 2012;16:81-6.
- Spagnuolo MI, Liquoro I, Chiatto F, Mambretti D, Guarino A. Application of a score system to evaluate the risk of malnutrition in a multiple hospital setting. Ital J Pediatr 2013;27:39-81.
- Marginean O, Pitea AM, Voidazan S, Marginean C. Prevalence and assessment of malnutrition risk among hospitalized children in Romania. J Health Popul Nutr 2014;32:97-102.
- Huong PT, Lam NT, Thu NN, Quyen TC, lien Dt, Anh NQ, et al. Prevalence of malnutrition in patients admitted to a major urban tertiary care hospital in Hanoi, Vietnam. Asia Pac J Clin Nutr 2014;23:437-44.
- Prieto MB, Cid JL. Malnutrition in the critically Ill child: The importance of enteral nutrition. Int J Environ Res Public Health 2011;8:4353-66.
- Mendez MA, Adair LS. Severity and timing of stunting in the first two years of life affect cognitive tests in late childhood. J Nutr 1999;129:1555-62.
- Altaş B, Kuloğlu Z. PEMlu çocuğa yaklaşım. Türkiye Çocuk Hast Derg 2011;5:54-64.
- Gündoğdu H. PEM. İç Hastalıkları Dergisi 2010;17:189-202.
- de Souza Menezes F, Leite HP, Koch Nogueira PC. Malnutrition as an independent predictor of clinical outcome in critically ill children. Nutrition 2012;28:267-70.
