Nutritional Status and Clinical Outcomes in Children with Cancer on Admission to Intensive Care Units

Abstract

Malnutrition is prevalent among pediatric oncology patients admitted to the pediatric intensive care unit (PICU), which leads to unfavorable clinical outcomes. This was a secondary data analysis of the nutrition data of 160 pediatric oncology patients admitted to the PICU. Cox’s regression (adjusted for sex, age, and pediatric critical illness score) and Chi-square were used to examine the association between nutritional status and outcomes. Most of the patients were diagnosed with leukemia and admitted to PICU for medical reasons. The prevalence of malnutrition was 11.3% according to weight-for-age z-score, 16.3% according to height-for-age z-score, 21.3% according to body mass index-for-age z-score, 14.4% according to weight-for-height z-score, 34.4% according to mid-upper arm circumference-for-age z-score. Anthropometrical parameters that predicted the duration of mechanical ventilation were weight-for-age (hazard ratio [HR], 2.727; 95% confidence interval [CI], 1.729-4.302); height-for-age (HR, 1.969; 95% CI, 1.440-2.693); weight-for-height (HR, 2.645; 95% CI, 1.575-4.441); and upper arm muscle area-for-age (HR, 2.098; 95% CI, 1.430–3.077). Length of PICU stay was predicted by weight-for-age (HR, 1.207; 95% CI, 1.014–1.436). Malnutrition is prevalent among pediatric oncology patients admitted to the PICU, which lead to unfavorable clinical outcomes. Comprehensive nutritional status assessment should be performed for these children.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Sheng Feng and Lei Cheng equally contributed to the conception and design of the research; Hua Lu and Nanping Shen contributed to the acquisition and analysis of the data; Sheng Feng and Lei Cheng contributed to the interpretation of the data; Sheng Feng, Lei Cheng, Hua Lu and Nanping Shen drafted the manuscript. All authors critically revised the manuscript, agree to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

Additional information

Funding

This study was supported by China National Natural Science Foundation of China Youth Science Foundation (No. 71904030, PI: Lei Cheng), and Shanghai Pujiang Talent Program (No.2019PJC006, PI: Lei Cheng).