Publication Date
3-20-2025
Journal
Children
DOI
10.3390/children12030390
PMID
40150673
PMCID
PMC11941274
PubMedCentral® Posted Date
3-20-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Introduction: Childhood malnutrition remains a risk factor for morbidity and mortality. Children admitted to the Pediatric Intensive Care Unit (PICU) are at a higher risk of worsening nutritional status with adverse clinical outcomes. The burden of malnutrition is strongly linked to various well-defined social determinants of health, including race, socioeconomic status, and geography, as these factors influence household food insecurity. This study aimed to analyze the interrelationships of nutritional status, social determinants of health, and health outcomes in critically ill children.
Methods: Retrospective cohort study of 6418 critically ill children admitted to PICU from January 2014 to December 2017. Demographic and anthropometric measurements were collected upon admission and outcomes. Based on the patient's zip code, and median household income, we estimated the percentage of the population living in poverty, and the percentage of the population experiencing food insecurity for 5912 children.
Results: The prevalence of underweight, chronic, and acute malnutrition was 13.2%, 17.9%, and 5.6%, respectively. Malnourished children had longer duration of mechanical ventilation and longer PICU and hospital lengths of stay (LOS) compared to nourished children. Underweight and chronic malnutrition were associated with higher mortality. Hispanic children had the highest prevalence of poverty level, while non-Hispanic Black children had the highest food insecurity level and lowest median income. Ethnicity was not associated with mortality.
Conclusions: Malnourished critically ill children who were disproportionately non-Hispanic Black, Hispanic, and Asian had worse hospital outcomes, including prolonged hospital and PICU length of stay, increased time on mechanical ventilation, and a higher risk of mortality.
Keywords
malnutrition, socioeconomic status, critically ill, pediatrics, intensive care, outcomes
Published Open-Access
yes
Recommended Citation
Desai, Yash; Marroquín, Andrea; Hong-Zhu, Paola; et al., "Nutritional Status, Social Determinants of Health and Clinical Outcomes in Critically Ill Children" (2025). Faculty and Staff Publications. 5740.
https://digitalcommons.library.tmc.edu/baylor_docs/5740