title: Impact of Malnutrition on the Outcome of Critically Ill Children.
abstract: OBJECTIVE
  To assess the impact of nutritional status on outcomes like mortality rate, length of mechanical ventilation and length of Pediatric Intensive Care Unit (PICU) stay, in critically ill children.
  
  
  METHODS
  In this retrospective study conducted at a tertiary care center, records of 332 critically ill children between 1 mo to 15 y of age for whom anthropometric parameters were available were included. Anthropometric parameters for the study subjects were used to assess the nutritional status using the WHO growth charts as the reference. The study subjects were categorized as non-malnourished, moderately, and severely malnourished, defined by Body mass index (BMI) for age 0 to -2 SD, -2 to -3 SD and less than -3 SD of WHO growth charts, respectively. Various outcomes like mortality, duration of PICU stay and duration of mechanical ventilation were assessed in the 3 groups based on the nutritional status.
  
  
  RESULTS
  The prevalence of malnutrition in the index study was 51.2 % with an overall mortality of 38.8 %. No difference was found between mortality rates and proportion of ventilated children in the three study groups. However, more children who were severely malnourished had significantly prolonged ICU stay (>7 d) as well as duration of mechanical ventilation (>7 d). When the outcome variables were compared after adjusting for PIM2 scores, there were increasing odds of mortality, ventilation, prolonged PICU stay and duration of mechanical ventilation with increasing severity of malnutrition.
  
  
  CONCLUSIONS
  After stabilization of the initial critical phase, PICU outcome is influenced by the nutritional status of the children.
authors: Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
authors: Narendra K
authors: NK
authors: Bagri
authors: Bipin
authors: B
authors: Jose
authors: Satish K
authors: SK
authors: Shah
authors: Tsultem D
authors: TD
authors: Bhutia
authors: Sushil K
authors: SK
authors: Kabra
authors: Rakesh
authors: R
authors: Lodha
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D015596:Nutrition Assessment; D009752:Nutritional Status / Q000502:physiology; D015995:Prevalence; D012121:Respiration, Artificial