Prevalence of Malnutrition in Pediatric Hospitals in Developed and In-Transition Countries: The Impact of Hospital Practices

Abstract

Presently, undernutrition still goes undetected in pediatric hospitals despite its association with poor clinical outcomes and increased annual hospital costs, thus affecting both the patient and the health care system. The reported prevalence of undernutrition in pediatric patients seeking care or hospitalized varies considerably, ranging from 2.5 to 51%. This disparity is mostly due to the diversity of the origin of populations studied, methods used to detect and assess nutritional status, as well as the lack of consensus for defining pediatric undernutrition. The prevalence among inpatients is likely to be higher than that observed for the community at large, since malnourished children are likely to have a pre-existent disease or to develop medical complications. Meanwhile, growing evidence indicates that the nutritional status of sick children deteriorates during the course of hospitalization. Moreover, the absence of systematic nutritional screening in this environment may lead to an underestimation of this condition. The present review aims to critically discuss studies documenting the prevalence of malnutrition in pediatric hospitals in developed and in-transition countries and identifying hospital practices that may jeopardize the nutritional status of hospitalized children.

Current Practices Using Pediatric Malnutrition Indicators: A Survey of Dietitians Working in Pediatrics

“…Failure to accurately diagnose PMN leads to increased costs due to longer length of stay, increased rates of complications and infection, higher mortality rates, and impaired cognitive development. [1][2][3][4][5][6][7][8][9][10][11][12] It impedes research with inaccurate and ill-defined terms such as failure to thrive and inconsistent criteria used among studies. 13 Survey results indicated respondents knew that some or most of the coding and billing staff in their facilities were aware of the PMN recommended indicators.…”

Prevalencia de desnutrición en niños y adolescentes en instituciones hospitalarias de América Latina: una revisión

“…Al comparar estas cifras con las identificadas por otros estudios realizados en países fuera de Latinoamérica, fue posible identificar cifras similares; una revisión que reunió datos de prevalencia de desnutrición de 15 países europeos y 2 estudios realizados en Canadá mostró para el indicador P/T, un rango entre 9 y 14,8%, usando como parámetro el encontrarse por debajo de dos desviaciones estándar 44 .…”

“…Lo anterior, pone en claro que el bajo peso para la talla a nivel hospitalario es un problema multifactorial, que, si bien es preocupante en países de recursos bajos debido al acceso limitado de alimentos o atención médica, también puede desencadenarse por otras causas como enfermedades en países en transición 44,48 .…”

Coding for Malnutrition in the Hospital: Does It Change Reimbursement?

“…When criteria other than the Academy/ASPEN consensus statement criteria have been used, the prevalence of pediatric malnutrition in US hospitals has varied widely. One summary reported rates between 2.6% and 24.5%, whereas others have reported rates between 6% and 51% . Bierman and colleagues reported that 30% of patients admitted to the pediatric ICU or pediatric unit were identified with PCM using the Academy/ASPEN consensus statement criteria (n = 1532), but only 33% of those were actually coded with PCM …”