title: Impact of malnutrition on pediatric risk of mortality score and outcome in Pediatric Intensive Care Unit.
abstract: OBJECTIVE
  This study was done to determine the effect of malnutrition on mortality in Pediatric Intensive Care Unit (PICU) and on the pediatric risk of mortality (PRISM) scoring.
  
  
  METHODS
  This was a prospective study done over 1 year. There were total 400 patients (1 month 14 years), who were divided into cases with weight for age <3(rd) centile and controls with ≥3(rd) centile of WHO charts. Cases were subdivided into mild/moderate (61-80% of expected weight for age) and severe malnutrition (<60%).
  
  
  RESULTS
  Out of total, 38.5% patients were underweight, and malnutrition was more in infancy, 61/104, i.e. 58.5% (P - 0.003). There was no significant difference in vitals at admission. Cases needed prolonged mechanical ventilation (P - 0.0063) and hospital stay (P - 0.0332) compared to controls. Mean and median PRISM scores were comparable in both the groups, but mortality was significantly higher in severely malnourished (P value 0.027).
  
  
  CONCLUSIONS
  Severe malnutrition is independently associated with higher mortality even with similar PRISM score. There is need to give an additional score to children with weight for age <60% of expected.
authors.affiliation: Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
authors.forename: Romi
authors.initials: R
authors.lastname: Nangalu
authors.affiliation: Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
authors.forename: Puneet Aulakh
authors.initials: PA
authors.lastname: Pooni
authors.affiliation: Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Bhargav
authors.affiliation: Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
authors.forename: Harmesh Singh
authors.initials: HS
authors.lastname: Bains
keywords: Anthropometric data; malnutrition; outcome in malnourished children; pediatric risk of mortality