Undernutrition and associated factors affect the length of hospital stay and costs in a children's hospital in Panama

Introduction: Pediatric patients are prone to undernutrition because of their higher nutrient requirements for growth and development. However, regardless of the numerous advances in the quality of clinical and nutritional care, its prevalence in hospitalized children has remained unimproved over the past years, which negatively influence clinical outcomes, such as longer length of hospital stay (LOS) and higher hospitalization costs in Panama. Objective: This study focused on identifying the current prevalence of undernutrition among hospitalized pediatric patients in a Children’s Hospital. Also, explored the significant variables which influenced pediatric patients’ LOS and costs. Methods: A cross-sectional study was conducted in hospitalized pediatric patients between the ages of 1 month and 14 years old within the period from January to June 2017. Collected data for this study included demographic data, nutritional status, nutrition support therapy, diagnosis category, patient’s severity, LOS, and costs. Results: Out of 352 pediatric patients, 15.1% had chronic undernutrition, 7.8% had acute undernutrition and just a 2.8% presented both, for an overall prevalence of undernutrition of 25.6%. The LOS ranged from 3 to 26 days, with an average of 8.3 days. On the other hand, the costs ranged from $867.30 to $7,516.60 USD, with an average of $2,418.75 USD. Multiple regression analysis showed significant associations between LOS and age (p=0.031), nutritional status (p<0.001), diagnosis category (p<0.001) and severity (p<0.001); and between costs and age (p=0.022), nutritional status (p<0.001), diagnosis category (p=0.001) and severity (p<0.001). Conclusions: A high prevalence of undernutrition was found in this study. Infants, undernourished patients, neurology patients and severe patients were associated with longer LOS and higher costs. A validated nutrition screening tool must be implemented in time to identify those pediatric patients with undernutrition and at risk of developing undernutrition in order to initiate appropriate nutritional intervention.