Do hospitalized pediatric patients have weight and blood pressure concerns identified?
OBJECTIVE
To assess the frequency and recognition of abnormal nutritional status and elevated admitting blood pressure (BP) in hospitalized children.


METHODS
From children aged 3 to 18 years who were hospitalized during 4 months of 2005 (n = 1143), a stratified sample of paper-based medical records were reviewed for demographics, anthropometric and BP measurements and interpretations, care related to nutrition and BP, and discharge diagnoses. Records of 317 of 337 (94%) selected patients were reviewed, and data from 277 of these patients (records with weight and height documented) were analyzed. US references were applied to assign body mass index and BP percentiles. Data were weighted to account for sampling.


RESULTS
A total of 51% of subjects were Medicaid/self-pay, with a median age of 9.1 years; and 20% of subjects were obese (14% overweight, 58% healthy weight, 8% underweight). Body mass index was plotted/calculated for 35% of subjects. Six percent of subjects had BP >99th percentile + 5 mm Hg (18% BP 95th to < or =99th percentile + 5 mm Hg). A nutrition referral was documented for 61% of subjects who were underweight and 39% of subjects who were obese. BP concerns were documented for 26% of subjects with BP >99th percentile + 5 mm Hg.


CONCLUSIONS
Many pediatric inpatients had abnormal nutritional status or elevated BP. Systems to improve interpretation of these measures, which are commonly obtained in pediatric hospital settings, are needed.
Department of Pediatrics, Children's Memorial Hospital, Chicago, IL 60614, USA.
Eric J
EJ
Sleeper
Adolfo J
AJ
Ariza
Helen J
HJ
Binns
D000293:Adolescent; D017677:Age Distribution; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D004282:Documentation; D005260:Female; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D008485:Medical Audit; D017057:Medically Uninsured / Q000706:statistics & numerical data; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D017678:Sex Distribution; D013851:Thinness / Q000453:epidemiology; D014481:United States / Q000453:epidemiology