Research Article
StatisticalRiskCharacteristicsandRiskScoringof
Hospital-AcquiredMalnutritionforPediatricPatients
KhreshnaSyuhada ,
1
DessieWanda ,
2
RistiNur’aini,
1
ChairunArdiantari,
2
andAyuSusilo
1
1
Statistics Research Division, Institut Teknologi Bandung, Bandung, Indonesia
2
Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
CorrespondenceshouldbeaddressedtoDessieWanda;dessie@ui.ac.id
Received 29 September 2019; Revised 27 April 2020; Accepted 12 May 2020; Published 9 June 2020
AcademicEditor:MohammedS.Razzaque
Copyright©2020KhreshnaSyuhadaetal.isisanopenaccessarticledistributedundertheCreativeCommonsAttribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properlycited.
Background.Malnutritionisaglobalhealthproblemandchallengeforeverycountry.Itmayoccurinanyformandaffectalllevels
of age including children. We pay particular attention to the so-called hospital-acquired malnutrition (HaM) for pediatric
patients.Ouraimwastoexplorestatisticalriskfactorsorcharacteristicsaswellastoforecastriskscoringforsuchmalnutrition.
Methods.isstudyemployedacross-sectionaldesigninvolvingchildrenfrom1monthto18yearsofagewhowerehospitalized
foratleast72hours.Weusedsecondarydatafrom308medicalrecordsofpediatricpatientswhowereadmittedtothehospitalin
2017.Weexcludedthedataifthepatienthadtumorsororganomegaly,fluidretention,anddehydration.HaMwasdetermined
basedonaweightlosseachdayduringhospitalizationuntilthedayofdischarge.Statisticaldataanalysisiscarriedoutforboth
descriptiveandinferentialstatistics.Ourpredictivemodelisyieldedbylinearregression,andriskscoringisobtainedthrough
logistic regression. Results. e findings showed several risk factors or characteristics for HaM prevalence: sex, age, medical
diagnosis, diet, nutrition route, and NEWS score. e early warning system to pediatric patients is conducted by calculating
malnutrition-at-riskinwhichavaluebeyond100.5isconsideredashavinghighpotentialriskforHaM. Conclusion.Nursesare
expectedtomonitorpediatricpatients’condition,includingmeasuringtheanthropometryregularly,inordertoidentifytheinitial
signsofHaM.
1.Background
Malnutritionisabroadtermtodescribeanyimbalancein
nutrition,eitherovernutritionorundernutrition.ecaseof
malnutritionmayoccurtopeopleintheresidential,see,for
example, Pal [1]; Yang et al. [2]; Headey et al. [3]; and
EkbrandandHaller¨ od[4],and/ortopatientsatthehospital,
e.g.,deAquinoandPhilippi[5];Barkeretal.[6];Joostenand
Hulst[7];Curtisetal.[8];GouveiaandSilva[9];Beseretal.
[10];Maiaetal.[11];andSanzetal.[12].Itisaninteresting
topicandstatisticallychallengingfromhealthpractitioners’,
includingnurses,andstatisticians’viewpoints.Inthisstudy,
wepayparticularattentiontotheso-calledhospital-acquired
malnutrition (HaM) for pediatric patients in a top referral
hospital in Indonesia.
Malnutrition, including malnutrition in hospital set-
tings,remainsaglobalissue.AstudyconductedbyPacheco-
Acostaetal.[13]showedthat50%ofpatientsinahospital
suffered from malnutrition. Malnutrition may occur when
patientsarefirstadmittedandmayworsenduringtheirstay.
According to one study conducted in Canada, 39.6% of
patientsfrom1monthto19yearsofagewhowereadmitted
toahospitalweremalnourished[14].Suchconditionscould
cause a deterioration of nutritional status during
hospitalization.
Moeenietal.[15,16]haveconductedstudiesinIranand
New Zealand and found that pediatric patients with good
nutritional status tend to have malnutrition. In addition, pe-
diatricpatientswithlow-moderatemalnutritionwillhavehigh
riskofhavingseveremalnutritionduringhospitalization.is
Hindawi
Journal of Nutrition and Metabolism
Volume 2020, Article ID 4305487, 8 pages
https://doi.org/10.1155/2020/4305487