Impact of malnutrition on pediatric risk of mortality score and outcome in Pediatric Intensive Care Unit

• Published in: Indian journal of critical care medicine Vol. 20; no. 7; pp. 385 - 390
• Main Authors: Nangalu, Romi, Pooni, Puneet, Bhargav, Siddharth, Bains, Harmesh
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer - Medknow Publications 01.07.2016; Medknow Publications and Media Pvt. Ltd; Jaypee Brothers Medical Publishers Ltd; Medknow Publications & Media Pvt Ltd
• Subjects: Child health; Health aspects; Malnutrition; Mortality; Pediatrics; malnutrition; Anthropometric data; pediatric risk of mortality; outcome in malnourished children
• ISSN: 0972-5229; 1998-359X
• DOI: 10.4103/0972-5229.186218

Objectives: This study was done to determine the effect of malnutrition on mortality in Pediatric Intensive Care Unit (PICU) and on the pediatric risk of mortality (PRISM) scoring. Subjects and Methods: This was a prospective study done over 1 year. There were total 400 patients (1 month 14 years), who were divided into cases with weight for age <3 rd centile and controls with ≥3 rd centile of WHO charts. Cases were subdivided into mild/moderate (61-80% of expected weight for age) and severe malnutrition (<60%). Results: Out of total, 38.5% patients were underweight, and malnutrition was more in infancy, 61/104, i.e. 58.5% (P - 0.003). There was no significant difference in vitals at admission. Cases needed prolonged mechanical ventilation (P - 0.0063) and hospital stay (P - 0.0332) compared to controls. Mean and median PRISM scores were comparable in both the groups, but mortality was significantly higher in severely malnourished (P value 0.027). Conclusion: Severe malnutrition is independently associated with higher mortality even with similar PRISM score. There is need to give an additional score to children with weight for age <60% of expected.