Undernutrition at PICU Admission Is Predictor of 60-Day Mortality and PICU Length of Stay in Critically Ill Children
Title
Undernutrition at PICU Admission Is Predictor of 60-Day Mortality and PICU Length of Stay in Critically Ill Children
Creator
Ventura J C; Hauschild D B; Barbosa E; Bresolin N L; Kawai K; Mehta N M; Moreno Y M F
Identifier
Publisher
Journal of the Academy of Nutrition and Dietetics
Date
2020
Subject
Adolescent; Anthropometry; Body Mass Index; Brazil/epidemiology; Child; Child Nutrition Disorders/*mortality; Critical Illness/*mortality; Female; Humans; Infant; Intensive Care Units; Length of stay; Length of Stay/*statistics & numerical data; Male; malnutrition; Mortality; Nutritional status; Patient Admission/*statistics & numerical data; Patient Discharge/statistics & numerical data; Pediatric intensive care unit; Pediatric/*statistics & numerical data; Predictive Value of Tests; Preschool; Proportional Hazards Models; Prospective Studies; Regression Analysis; Time Factors
Description
BACKGROUND: There are few studies that assess the role of different nutritional assessment variables at pediatric intensive care unit (PICU) admission in predicting clinical outcomes. OBJECTIVE: To identify nutritional variables in the first 4 days of PICU stay that predict 60-day mortality and time to discharge alive from the PICU. DESIGN: Single-center prospective study in Southern Brazil, conducted between July 2013 and February 2016. At PICU admission, children with z scores <-2 for body mass index (BMI)-for-age, mid-upper arm circumference (MUAC)-for-age, and triceps skinfold thickness (TSF)-for-age were considered as undernourished. PARTICIPANTS/SETTING: There were 199 patients, aged <15 years, with PICU stay >48 hours. MAIN OUTCOME MEASURES: Sixty-day mortality and time to discharge alive from the PICU. STATISTICAL ANALYSIS PERFORMED: Cox regression model was applied to determine predictors of 60-day mortality and time to discharge alive from the PICU. RESULTS: Median age was 23.1 months (interquartile range=3.9 to 89.1), and 63% were male, with 18% prevalence of undernutrition at admission by BMI-for-age. Median PICU stay was 7 days (interquartile range=4 to 12), and 60-day mortality was 12%. After adjusting for sex, age, Pediatric Index of Mortality 2, and presence of complex chronic conditions, undernutrition based on BMI-for-age (hazard ratio [HR]=3.75; 95% CI=1.41 to 9.95; P=0.008), MUAC-for-age (HR=7.62; 95% CI=2.42 to 23.97; P=0.001), and TSF-for-age (HR=4.01; 95% CI=1.14 to 14.15; P=0.031) was associated with higher risk of 60-day mortality. Based on MUAC-for-age with the same adjustment model, undernourished children had longer time to discharge alive from the PICU (HR=0.45; 95% CI=0.21 to 0.98; P=0.045). CONCLUSIONS: Undernutrition at PICU admission based on different anthropometric variables was predictive of 60-day mortality and longer time to discharge alive from the PICU.
Rights
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Citation List Month
November 2020 List
URL Address
Collection
Citation
Ventura J C; Hauschild D B; Barbosa E; Bresolin N L; Kawai K; Mehta N M; Moreno Y M F, “Undernutrition at PICU Admission Is Predictor of 60-Day Mortality and PICU Length of Stay in Critically Ill Children,” Pediatric Palliative Care Library, accessed April 18, 2025, https://pedpalascnetlibrary.omeka.net/items/show/17269.