Risk factors of hospital-acquired malnutrition in children: A study in a rural hospital of West Borneo, Indonesia

Abstract

Introduction: Hospital-acquired malnutrition (HAM) is prevalent among hospitalised children in developing countries. This condition relates to worse clinical outcomes, prolongs length of stay in hospitals, and increases mortality. A multidisciplinary approach should be performed to prevent and manage this problem. However, HAM is often underdiagnosed, especially in rural hospitals with limited human resources. This study aims to delineate the risk factors of HAM among hospitalised children in a rural hospital. Methods: This nested case-control study derived from the implementation of a nutritional screening programme in Parindu Hospital, Sanggau, West Borneo, was conducted from December 2018 to February 2019. HAM was defined as a loss of body weight of >2% after hospitalisation. Independent variables such as the age of patients, fever, gastrointestinal loss, pre-existing malnutrition, length of stay, and grade of disease were analysed in univariate and multivariate analyses using logistic regression. Risk factors were expressed as odds ratio and adjusted odds ratio (aOR) with 95% confidence interval (CI). Results: Thirty-three patients were analysed as cases with 59 controls. Median age was younger in the case group (49 months, IQR 14-72.5) than control group (88 months, IQR 43-116). After adjustment for other covariates, age <5 years old (aOR 5.50, 95% CI 1.95- 15.59) and moderate-to-severe grade of disease (aOR 3.50, 95% CI 1.09-11.09) were significant risk factors of HAM in our study. Conclusion: Risk factors of HAM in children hospitalised in a rural hospital were age <5 years old and moderate-tosevere grade of disease.

Application of STRONGkids method on assessing the risk of malnutrition among hospitalised children in Universitas Sebelas Maret Hospital

“…Underlying disease and nutritional status were significant risk factors for the occurrence of HM in our study subjects. These findings support a previous study conducted in several hospitals in Bali and West Borneo, which reported that a high risk of HM was significantly associated with chronic, moderate-to-severe disease and nutritional status (Sidiartha, 2018;Prasetya, Haryanti & Nurani, 2021). Malnutrition is a pathological condition affecting most children.…”

“…This current study revealed that HM was more common in toddlers (50.9%). A previous study reported that age <5 years old was a risk factor of HM in children hospitalised in a rural hospital (Prasetya, Haryanti & Nurani, 2021). Similarly, another study found that children under 60 months old were more likely to suffer from hospital-acquired malnutrition (Spagnuolo et al, 2013).…”

Effect of Diagnosis, Complications, and Nutrition for Using Nasogastric Tube to Body Weight of Child Patients with Feeding Difficulty at Dr. M. Djamil General Hospital, Padang, Indonesia

“…deficiencies can increase the risk of serious health complications, such as anemia, osteoporosis, and heart failure. [1][2][3][4] A nasogastric tube (NGT) is an option for providing enteral nutrition to children who have difficulty eating.…”