• Christina Hecht, Martina Weber, Veit Grote, Efstratia Daskalou, Laura Dell'Era, Diana Flynn, Konstantinos Gerasimidis, Frederic Gottrand, Corina Hartman, Jessie Hulst, Koen Joosten, Thomais Karagiozoglou-Lampoudi, Harma A Koetse, Sanja Kolaček, Janusz Książyk, Tena Niseteo, Katarzyna Olszewska, Paola Pavesi, Anna Piwowarczyk, Julien Rousseaux, Raanan Shamir, Peter B Sullivan, Hania Szajewska, Angharad Vernon-Roberts, and Berthold Koletzko.
• Div. Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany.
• Clin Nutr. 2015 Feb 1; 34 (1): 53-9.

Background & AimsPrevious studies reported a wide range of estimated malnutrition prevalence (6-30%) in paediatric inpatients based on various anthropometric criteria. We performed anthropometry in hospitalised children and assessed the relationship between malnutrition and length of hospital stay (LOS) and complication rates.MethodsIn a prospective multi-centre European study, 2567 patients aged 1 month to 18 years were assessed in 14 centres in 12 countries by standardised anthropometry within the first 24 h after admission. Body mass index (BMI) and height/length <-2 standard deviation scores (SDS, WHO reference) were related to LOS (primary outcome), frequency of gastrointestinal (diarrhoea and vomiting) and infectious complications (antibiotic use), weight change during stay (secondary outcomes) and quality of life.ResultsA BMI <-2 SDS was present in 7.0% of the patients at hospital admission (range 4.0-9.3% across countries) with a higher prevalence in infants (10.8%) and toddlers aged 1-2 years (8.3%). A BMI <-2 to ≥-3 SDS (moderate malnutrition) and a BMI <-3 SDS (severe malnutrition) was associated with a 1.3 (CI95: 1.01, 1.55) and 1.6 (CI95: 1.27, 2.10) days longer LOS, respectively (p = 0.04 and p < 0.001). Reduced BMI <-2 SDS was also associated to lower quality of life, and more frequent occurrence of diarrhoea (22% vs 12%, p < 0.001) and vomiting (26% vs 14%, p < 0.001).ConclusionDisease associated malnutrition in hospitalised children in Europe is common and is associated with significantly prolonged LOS and increased complications, with possible major cost implications, and reduced quality of life. This study was registered at clinicaltrials.gov as NCT01132742.Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

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