Volume 6, Issue 3, September 2020, Page: 381-385
Comorbid Diseases Is a Predictor Length of Stay in Children with Severe Acute Malnutrition
Made Laksmi Dewi Adnyana, Department of Child Health, Faculty of Medicine, Udayana University, Denpasar, Indonesia
I Gusti Lanang Sidiartha, Department of Child Health, Faculty of Medicine, Udayana University, Denpasar, Indonesia
I Gusti Ayu Eka Pratiwi, Department of Child Health, Faculty of Medicine, Udayana University, Denpasar, Indonesia
Received: Aug. 27, 2020;       Accepted: Sep. 16, 2020;       Published: Sep. 23, 2020
DOI: 10.11648/j.ajp.20200603.45      View  48      Downloads  36
Abstract
Severe acute malnutrition (SAM) is one of the leading causes of morbidity and mortality in children in developing countries. Patient with SAM mostly hospitalized with comorbidity that reduce the time of recovery and longer the length of stay (LOS). The aim of this study is to determine the association between comorbid with longer LOS among children with SAM. This was a retrospective cohort study from 2017-2018 on children with SAM conducted in the pediatric care ward of Sanglah Denpasar General Hospital. Inclusion criteria was children aged 1 months to 18 years diagnosed with SAM and had complete data at the start of admission. Exclusion criteria was patient discharged against medical advice. 134 children with SAM were included and analyzed with appropriate statistical analysis. The median of LOS was 18 days, comorbid at admission found were infection (31.3%), non-infection (56.0%), both infection and non-infection (12.7%). HIV found as the most comorbid in SAM patient (21.3%) followed by malignancy (17.3%), congenital heart disease (14%), and pneumonia (12.7%). Multivariate analysis found that comorbid was a risk factor for longer LOS in hospitalized SAM patients. Comorbid increases the LOS by 3.23 times (95% CI 1.563-6.709) p value 0.002. Bivariate analysis found that infection as comorbid increase the LOS by 1.72 times (95% CI 1.171-2.524) p value 0.011. Conclusion that comorbid at admission was associated with longer LOS in hospitalized patient with SAM.
Keywords
Severe Acute Malnutrition, Comorbid, Length of Stay, Children
To cite this article
Made Laksmi Dewi Adnyana, I Gusti Lanang Sidiartha, I Gusti Ayu Eka Pratiwi, Comorbid Diseases Is a Predictor Length of Stay in Children with Severe Acute Malnutrition, American Journal of Pediatrics. Vol. 6, No. 3, 2020, pp. 381-385. doi: 10.11648/j.ajp.20200603.45
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Kusnandi V, Wiramihardja S, Adithya AP, Gurnida DA. Factors influencing outcome of children hospitalized with acute severe malnutrition. AMJ. 2018; 5 (2): 87-92.
[2]
Riset Kesehatan Dasar. Penelitian dan Pengembangan Kesehatan Kementerian RI tahun 2013 [cited 19 Februari 2018]. Available from: http://www.depkes.go.id/resources/download/general/Hasil%20Riskesdas
[3]
Hulst J, Joosten K, Zimmermann L, Hop W, Van Buuren S, Büller H, et al. Malnutrition in critically ill children: from admission to 6 months after discharge. Clin Nutr. 2004; 23: 223–32.
[4]
Dejenu G, Esthetie S, Alebel A, Worku W, Abajobir AA. Treatment cure rate and its predictors among children with severe acute malnutrition in Northwest Ethiopia: A retrospective record review. PLOS ONE. 2019: 1-13.
[5]
Arya AK, Lal P, Kumar P. Co-morbidities in children with severe acute malnutrition –A tertiary care centre experience. IJCMR. 2017; 4: 1086-88.
[6]
Mena MB, Dedefo, MG, Biloro BB. Treatment outcome of severe acute malnutrition and its determinants among pediatric patients in West Ethiopia. Hindawi International Journal of Pediatrics. 2018: 1-7.
[7]
Ahmed T, Hossain M, Mahfuz M, Choudhury N, Hossain MM, Bhandari N, Lin MM, Joshi CP, Angdembe MR, Wickramasinghe P, Sjahjahan M, Irianto SE, Soofi S, Bhutta Z. Severe acute malnutrition in Asia. Food Nutr Bull. 2014; 35: 24-7.
[8]
Roy SK, Buis M, Weersma R, Khatun W, Chowdhury S, Begum A, et al. risk Factor of mortality in severely-malnourished children hospitalized with diarrhea. J Health Popul Nutr. 2011; 29 (3): 229-235.
[9]
C. Y. Chang, I. Trehan, R. J. Wang. Children successfully treated for moderate acute malnutrition remain at risk for malnutrition and death in the subsequent year after recovery. Journal of Nutrition. 2013; 143 (2): 215–220.
[10]
Saaka M, Osman SM, Amponsem A, Ziem JB, Mumin AA, Akanbong P, Yirkyio E, Yakubu E, Ervin S. Treatment outcome of severe acute malnutrition cases at the Tamale Teaching Hospital. Journal of Nutrition and Metabolism. 2015: 1-8.
[11]
Amsalu S, Asnakew G. The outcome of severe malnutrition in northwest Ethiopia: retrospective analysis of admissions. Ethiopian Medical Journal. 2006; 44 (2): 151–57.
[12]
Singh K, Badgaiyan N, Ranjan A, Dixit H, Kaushik A, Kushwaha K, et al. Management of children with severe acute malnutrition: Experience of nutrition rehabilitation centers in Uttar Pradesh, India. Indian Pediatr. 2014; 51 (1): 21–5.
[13]
Egata G, Berhane Y, Worku A. Predictors of acute undernutrition among children aged 6 to 36 months in east rural Ethiopia: a community based nested case-control study. BMC Pediatr. 2014; 14 (1): 1.
[14]
Arya AK, Kumar P, Midha T, Singh M. hematological profile of children with severe acute malnutrition in a tertiary care centre experience. Int J Contemp Pediatr. 2017; 4 (5): 1577-80.
[15]
Yang W, Li X, Li Y, Zhang S, Liu L, Wang X, Li, W. Anemia, malnutrition and their correlations with socio-demographic characteristics and feeding practices among infants aged 0–18 months in rural areas of Shaanxi province in northwestern China: a cross-sectional study. BMC Public Health. 2012; 12: 1127-14.
[16]
Correia MITD, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr 2003; 22: 235–9.
[17]
Desta KS. Survival Status and Predictors of Mortality among Children Aged 0-59 Months with Severe Acute Malnutrition Admitted to Stabilization Center at Sekota Hospital Waghemra Zone. J Nutr Disorders Ther. 2015; 5: 1-11.
[18]
Wagnew F, Tesgera D, Mekonnen M, Abajobir AA. Predictors of mortality among under-five children with severe acute malnutrition, Northwest Ethiopia: an institution based retrospective cohort study. Arch Public Health. 2018; 76: 1-10.
[19]
Munthali T, Jacobs C, Sitali L, Dambe R, Michelo C. Mortality and morbidity patterns in under-five children with severe acute malnutrition (SAM) in Zambia: a five-year retrospective review of hospital-based records (2009–2013). Archives of Public Health. 2015; 73 (1): 156-61.
[20]
Chane T, Oljira L, Atomesa GE, Agedew E. Treatment Outcome and Associated Factors among Under- Five Children with Severe Acute Malnutrition Admitted to Therapeutic Feeding Unit in Woldia Hospital, North Ethiopia. Journal of Nutrition & Food Sciences. 2014; 4 (6): 115-19.
[21]
Muoneke VU, Ibekwe RC, Nebe-Ugamadu HU, Ibe BC. factors associated with mortality in under-five children with severe anemia in Ebonyi, Nigeria. Indian Pediatr. 2012; 49: 119-123.
[22]
Gebremichael DY. Predictors of nutritional recovery time and survival status among children with severe acute malnutrition who have been managed in therapeutic feeding centers, Southern Ethiopia: retrospective cohort study. BMC public health. 2015; 15 (1): 120-28.
[23]
Joosten KF, Hulst JM. Prevalence of malnutrition in pediatric hospital patients. Curr Opin Pediatr. 2008; 20 (5): 590–6.
[24]
Jarso H, Workicho A, Alemseged F. Survival status and predictors of mortality in severely malnourished children admitted to Jimma University Specialized Hospital from 2010 to 2012, Jimma, Ethiopia: a retrospective longitudinal study. BMC Pediatrics. 2015; 15: 1-3.
[25]
Thakur N, Chandra J, Pemde H, Singh V. anemia in severe acute malnutrition. Nutrition. 2014; 30: 440-442.
Browse journals by subject