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. 2023 May 30;23(1):271.
doi: 10.1186/s12887-023-04087-x.

Undernutrition and 60-day mortality in critically ill children with respiratory failure: a prospective cohort study

Sina Amirjani  1 , Narjes Ahmadizadeh  2 , Azita Behzad  2 , Yasaman Dadashi-Noshahr  1 , Zahra Vahdat Shariatpanahi  3   4
Affiliations

Undernutrition and 60-day mortality in critically ill children with respiratory failure: a prospective cohort study

Sina Amirjani et al. BMC Pediatr. .

Abstract

Background: To determine whether undernutrition affects 60-day mortality in pediatric acute respiratory failure.

Methods: Subjects with acute respiratory failure aged between two months and 13 years were included in the study. The Z-scores were calculated on admission and children were categorized into two groups of undernutrition and normal nutrition. The nutritional intake of the children was measured daily. The outcome was 60-day mortality.

Results: A total of 126 patients met the inclusion criteria; 41% were undernourished based on the Z-score of BMI and weight for height, 50% based on the Z-score of height and length for age and 45% based on the Z-score of weight for age. Overall, the 60-day mortality rate was 27.8%. The Cox regression analysis adjusted with PIM2, age and gender, showed that undernutrition has a significant relationship with 60-day mortality based on the weight for age Z-score (HR = 2.33; CI: 1.175-4.638). In addition, undernutrition has a significant relationship with 60-day mortality based on the BMI for age (HR = 3.04; CI:1.070-8.639) and weight for height (HR = 2.62; CI: 1.605-6.658) Z-scores. The mean calorie and protein intake of 72% of the children was less than 80% of their calorie needs. The time to start feeding in 63% of the children was more than 48 h. There was no relationship between the time of starting nutrition and nutritional intake during PICU admission and mortality.

Conclusion: Undernutrition is prevalent in mechanically ventilated children in the PICU and may be associated with 60-day mortality.

Keywords: Mortality; Nutritional status; PIM2; Underfeeding.

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Conflict of interest statement

Authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of subjects
Fig. 2
Fig. 2
Survival rates of participants compared between two groups of nutritional status based on Z score BMI for age and weight for length (upper) and weight for age (lower)
See this image and copyright information in PMC

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