Low Total Lymphocyte Count as the Risk of Hospital Acquired Malnutrition in Children

Abstract

Background: Hospital Acquired Malnutrition (HAM) is characterized by inadequate nutritional therapy and the risk of developing malnutrition during the hospital stay. In clinical practice, there are many measurements to determine nutritional status. Total lymphocyte count (TLC) is associated with impaired function of immune system in malnutrition. The purpose of this study was to evaluate the prognostic value of TLC to the occurrence of HAM in pediatric patients.Materials and Methods: This an observational study with a prospective cohort design. Subjects were assessed for weight at the first day of hospitalization, then the subjects were followed until they were discharged. Body weight was re-measured on discharge to determine the presence or absence of HAM. This research was conducted at Sanglah Hospital from May-December 2019. Subjects who met the inclusion and exclusion criteria were enrolled in the study.Results: Among 120 subjects, 55 subjects or 45.8% were malnourished on admission. Subjects with a low TLC compared to a normal TLC had a 3.9-fold risk of experiencing hospital acquired malnutrition (95% Confidence Interval: 1.59 to 7.19, p=0.001). Subjects who had a low TLC had HAM of 61.8%, while subjects who had a normal TLC had HAM of 32.3%. In multivariate analysis, low TLC was the only risk factor for HAM in this research.Conclusion: This study proved that low TLC is the risk of HAM. Total lymphocyte count could be used as predictor of the risk of HAM in hospitalization children.Keywords: hospital malnutrition, total lymphocyte, children

Effect of high-calorie formula on weight, height increment, IGF-1 and TLC in growth faltering children: A quasi-experimental study

“…The TLC can be used to detect malnutrition. Children with a low TLC on admission to hospital had a 3.9-fold risk of hospital-acquired malnutrition [ 18 ]. An ONS is useful to improve immune function, inflammatory response and treatment efficacy in cancer patients [ 70 ].…”

“…Undernutrition accompanied by infection also decreases B lymphocyte subsets (such as CD20 + ), which is caused by malnutrition-related immunodeficiency [ 17 ]. Total lymphocyte count (TLC) has been used as one prognostic variable to detect malnutrition because its decrease can be correlated with malnutrition [ 18 , 19 ].…”

OXTR Gene mRNA Expression is Correlated to Prosocial Behavior of Children in the Golden Generation Program of Nusa Tenggara Barat

“…Authors relay that other factors may influence the development of prosocial behavior including nutritional intake and the history of hospitalization as well as chronic infection such as tuberculosis. (36,37) This study use the non-prospective design and not all factors that may influence prosocial behavior were observed, therefore future research supposed to be delivered with better design and control of other confounding factors.…”

The Use of STRONGkids, Total Lymphocyte Count, and Serum Albumin to Identify the Risk of Hospital Malnutrition in Children

“…Using a cut-off value of 4,000 cells/mm 3 , children between the ages of 6 and 12 months were found to have a 61.8% hospital malnutrition incidence rate and a 32.3% rate of normal TLC, as well as a 3.9 times higher risk of hospital malnutrition for those with low TLC, with a 95% confidence interval between 1.5 and 7.1. These data suggested that low TLC levels can be used to predict the development of hospital malnutrition (Ekaputri et al 2021).…”