Research Article
Missed Opportunities for Nutritional Rehabilitation in
Children Admitted to Surgical Wards
Pooja Dave,
1,2
Somashekhar Nimbalkar,
2
Ajay Phatak,
3
Rajendra Desai,
3
and Shirish Srivastava
1
1
Department of Surgery, Pramukhswami Medical College, Charutar Arogya Mandal, Karamsad, Gujarat 388325, India
2
Department of Pediatrics, Pramukhswami Medical College, Charutar Arogya Mandal, Karamsad, Gujarat 388325, India
3
Central Research Services, Chautar Arogya Mandal, Karamsad, Gujarat 388325, India
Correspondence should be addressed to Somashekhar Nimbalkar; somu somu@yahoo.com
Received 31 December 2015; Revised 9 May 2016; Accepted 23 May 2016
Academic Editor: Cosimo Sperti
Copyright © 2016 Pooja Dave et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background. Malnutrition in children has serious health and economic consequences. We studied documentation of malnutrition,
actual prevalence, and treatment given in children admitted to surgical wards. Methods. Retrospective study of 154 patients aged
<5 yrs admitted to general surgical, orthopedic, and otorhinolaryngology wards. Records were evaluated for completeness of data,
way of documentation, and data quality. Descriptive analysis was done. If malnutrition was not identifed and/or proper action
was not taken, it was defned as a “missed opportunity.” Results. Of 154 records audited, 100 (64.94%) were males, 108 (70.13%)
were from general surgery ward, and 78 (50.65%) were residing in suburban area. Te mean (SD) age of the study population
was 2.32 (1.16) years whereas mean (SD) duration of stay was 5.84 (6.29) days. Weight and height were mentioned in 116 (75.32%)
and 8 (5.19%) records, respectively, mostly by nonsurgical personnel. Documentation and treatment of malnutrition were poor.
Out of 106 apparently correct weight records, 19 (17.93%) children were severely undernourished and 30 (28.30%) were moderately
undernourished whereas 20 (18.87%) children were not undernourished but required nutritional attention. Conclusion. Tere is
poor documentation of nutritional indicators of children admitted to surgical wards. From data that was available, it is apparent
that malnutrition is at high levels. “Identifcation” and hence management of malnutrition need more attention.
1. Introduction
Approximately 60 million children, under fve, accounting
for nearly 50% of all India’s children are underweight, about
45% children are stunted, and 20% are wasted, suggesting
acute malnutrition [1]. Malnutrition among Indian children
is twice higher than that in Sub-Saharan Africa and almost
fve times higher than in China [1]. To improve nutritional
status in children under 6 and maternal health, Integrated
Child Development Services (ICDS) Scheme was launched
in 1975 [2]. Since then, many measures have been taken to
combat the condition resulting in a decline in its prevalence.
But decline has been slower than what has been achieved in
other countries with comparable socioeconomic indicators
[3]. Malnutrition contributes signifcantly to some of the
most common causes of mortality in children, in developing
countries like India [4].
Malnutrition has been identifed in the hospitalized pop-
ulation, up to 25–50% in industrialized as well as developing
countries, for more than a decade [5–13]. About 40% of
malnutrition was found in Intensive Care Unit (ICU) patients
[14] as well as under-fve children admitted to pediatric
ward [15] in two Indian hospitals. Hospital malnutrition is
associated with higher rates of morbidity and mortality [12,
16]. Te mortality rate of children with complicated severe
acute malnutrition that receive treatment in inpatient setups
has remained unacceptably high [17]. Hospital malnutrition
is associated with delayed recovery, prolonged hospital stay,
and increased healthcare costs and a higher early readmission
rate [12, 16–18]. Moreover, deterioration of nutritional status
Hindawi Publishing Corporation
Scientifica
Volume 2016, Article ID 3470621, 5 pages
http://dx.doi.org/10.1155/2016/3470621