Malnutrition in hospitalized children with congenital heart disease
J. W. Cameron, A. Rosenthal and A. D. Olson
Division of Health Promotion and Risk Reduction, University of Michigan School of Nursing, Ann Arbor, USA.
OBJECTIVE: To determine the prevalence of malnutrition among hospitalized
children with congenital heart disease by age, disease process, and
clinical status. DESIGN: Cross-sectional, retrospective chart review.
SETTING: Pediatric cardiology units at a 150-bed tertiary care teaching
hospital in Ann Arbor, Mich. PATIENTS: Patients (n = 160) were randomly
selected from consecutive admissions to the Pediatric Cardiology and
Thoracic Surgery Services during a 1-year period. INTERVENTION: None. MAIN
OUTCOME MEASURES: Acute and chronic malnutrition, assessed by comparing the
patients' weight and height with established means. RESULTS: Acute and
chronic malnutrition occurred in 33% and 64% of the patients, respectively.
Age, diagnostic category, and symptoms were associated with malnutrition.
Eighty percent of infants presented with acute malnutrition compared with
18% of patients of other ages (P < .001). Malnutrition affected 60% of
patients with left-to-right shunts, 53% of patients with complex heart
disease, and no patients with primary rhythm disturbances. Acute
malnutrition affected 11% and chronic malnutrition affected 50% of patients
with left-sided heart obstruction. Acute or chronic malnutrition occurred
in 70% or more of patients with cyanosis and/or congestive heart failure
but in only 30% of patients with neither (P < .001). CONCLUSION:
Malnutrition in hospitalized children with congenital heart disease remains
common, highlighting the importance of nutritional screening and
intervention.
