Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Jun 9, 2025; 14(2): 103377
Published online Jun 9, 2025. doi: 10.5409/wjcp.v14.i2.103377
Impact of nutritional status on the outcome of critically ill pediatric patients
Samriddhi Jain, Amit Agrawal, Shweta Sharma, Ramkumar Chinnadurai
Samriddhi Jain, Amit Agrawal, Shweta Sharma, Ramkumar Chinnadurai, Department of Pediatrics, Gandhi Medical College, Bhopal 462022, Madhya Pradesh, India
Author contributions: Jain S contributed to acquisition and interpretation of data, data analysis, drafting the article, and literature review; Chinnadurai R contributed to interpretation of data and data analysis, drafting the article, and literature review; Sharma S contributed to data analysis, manuscript review, manuscript editing, Agrawal A contributed to concept, manuscript review, manuscript editing, revising the article critically for important intellectual content; Agrawal A will act as guarantor. All the authors approved the final manuscript.
Institutional review board statement: Prior approval from the institutional ethical committee was obtained (IEC Protocol no. – 106/IEC/2021).
Informed consent statement: Informed consent from parents/Legal guardians was obtained before recruiting the patients.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: sharing statement: Available with the corresponding author and will be made available upon request by the journal's editor.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amit Agrawal, MD, Associate Professor, Department of Pediatrics, Gandhi Medical College, Hamidia Hospital Campus 49-B, Indrapuri, B-Sector, Bhopal 462022, India. agrawaldramit@yahoo.co.in
Received: November 18, 2024
Revised: January 24, 2025
Accepted: February 27, 2025
Published online: June 9, 2025
Processing time: 120 Days and 14.8 Hours
Abstract
BACKGROUND

Malnutrition among patients admitted to a pediatric intensive care unit (PICU) is common. However, there is a lack of data on its impact on the critically ill.

AIM

To assess the impact of nutritional status on the outcome of critically ill children admitted to PICU.

METHODS

This observational study was conducted in a tertiary care teaching institute for one year, including 210 children aged 1 month to 14 years admitted to a 15-bed PICU for a minimum of 24 hours. Patients with less than 24 hours of PICU stay, who received palliative care, or with syndromic short stature were excluded. Relevant data were collected including anthropometric details, demographic data, duration of mechanical ventilation (MV), PICU, and hospital stay and outcome. Malnourished and well-nourished groups were compared using an independent t-test, one-way analysis of variance, and χ2 test.

RESULTS

Among 210 patients, there were 129 males and 81 females. There were 57 (27.1%) children less than 6 months of age, 95 (45.2%) between 6 months and 5 years, and 58 (27.6%) more than 5 years of age. The prevalence of malnutrition in the study sample was 51.9% (n = 109). The overall mortality was 22.9% (48/210), 26.6% (29/109) among malnourished, and 18.8% (19/101) among well-nourished children (P = 0.241). A significant association was found between the severity of malnutrition and duration of MV (P = 0.001), PICU stay (P = 0.001), and hospital stay (P = 0.021).

CONCLUSION

Malnutrition is common in critically ill children and contributes to poor clinical outcomes such as duration of MV, PICU, and hospital stay. However, mortality was comparable in both groups.

Keywords: Well-nourished; Malnourished; Pediatric intensive care unit; Mortality; Critically ill; Child

Core Tip: Malnutrition is prevalent among critically ill children admitted to pediatric intensive care unit (PICU). This study aimed to assess the impact of malnutrition on patient outcomes. Researchers analyzed data from 210 children aged 1 month to 14 years and malnutrition was identified in 51.9% of patients. While mortality rates were similar between malnourished and well-nourished groups, the former experienced significantly longer durations of mechanical ventilation, PICU stay, and overall hospital stay. These findings highlight the importance of early nutritional assessment and intervention in critically ill children to improve clinical outcomes.