Research Article

Karakteristik malnutrisi rumah sakit pada pasien anak di RSUP Sanglah, Bali, Indonesia

Hanzelina Hanzelina , I Gusti Lanang Sidiartha, I Gusti Ayu Putu Eka Pratiwi

Hanzelina Hanzelina
Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia. Email: hanzel2gretel@gmail.com

I Gusti Lanang Sidiartha
Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia

I Gusti Ayu Putu Eka Pratiwi
Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia
Online First: August 31, 2021 | Cite this Article
Hanzelina, H., Sidiartha, I., Pratiwi, I. 2021. Karakteristik malnutrisi rumah sakit pada pasien anak di RSUP Sanglah, Bali, Indonesia. Intisari Sains Medis 12(2): 666-671. DOI:10.15562/ism.v12i2.1079


Background: Hospital Malnutrition (HM) is malnutrition diagnosed while being treated at the hospital either when admitted to the hospital, during treatment or even when discharged from the hospital, which is closely related to hospital care. The incidence of HM is still quite high and can increase morbidity and mortality among inpatient children. This study aims to determine the characteristics of in-hospital malnutrition cases in children undergoing treatment at Sanglah Hospital.

Methods: This study used a prospective cohort design using primary data obtained from interviews and anthropometry of 120 children hospitalized at Sanglah Hospital in the 2019-2020 period. HM was defined as a decrease in a Z-score of Weight/Height (W/H) > 0.5 Standard Deviation (SD) at the time of hospital discharge. Data were analyzed using SPSS version 20 for Windows.

Results: The incidence of HM was 47.1%, of which 54.0% of patients were female. The incidence of in-hospital malnutrition was primarily found in patients aged 1-3 years (50.0%) and >5 years (42.0%). Approximately 64.0% of children with HM were malnourished before being admitted to the hospital and 14.0% got parenteral nutrition. It was found that 72% of children with HM had a hospital stay length of > 7 days. More than half of children with HM (56.0%) have parents with low levels of education (less than secondary education) and 58.0% have more than 3 siblings.

Conclusion: The incidence of hospital malnutrition is more often found in girls, age >5 years old, malnutrition before admitted, get parenteral nutrition, had parents with low education levels, number of siblings > 3, had a single diagnosis and length of stay > 7 days. 

 

Latar Belakang: Malnutrisi rumah sakit (MRS) adalah malnutrisi yang didiagnosis saat dirawat di Rumah Sakit (RS) baik saat masuk RS, selama perawatan atau bahkan saat pasien keluar dari rumah sakit yang erat kaitannya dengan perawatan di RS. Kejadian MRS masih cukup tinggi dan dapat meningkatkan morbiditas dan mortalitas pada anak yang dirawat. Penelitian ini bertujuan untuk mengetahui karakteristik dari kasus MRS pada anak yang menjalani perawatan di RSUP Sanglah.

Metode: Studi ini menggunakan desain kohort prospektif dengan menggunakan data primer dari wawancara dan pemeriksaan antropometri terhadap 120 anak yang dirawat inap di RSUP Sanglah pada periode 2019-2020. MRS didefinisikan sebagai penurunan Z-score Berat Badan/Tinggi Badan (BB/TB) > 0,5 Standard Deviation (SD) pada saat keluar RS. Data dianalisis dengan SPSS versi 25 untuk Windows.

Hasil: Kejadian MRS ditemukan sebanyak 47,1% dengan 54,0% sampel berjenis kelamin perempuan. Insidens MRS paling banyak ditemukan pada pasien kelompok usia 1-3 tahun (50,0%) dan >5 tahun (42,0%). Sebanyak 64,0% anak dengan MRS sudah mengalami malnutrisi sebelum masuk RS dan 14,0% mendapatkan nutrisi parenteral. Ditemukan bahwa 72,0% anak dengan MRS memiliki lama rawat di RS >7 hari. Lebih dari separuh anak dengan MRS (56,0%) memiliki orang tua dengan tingkat pendidikan rendah (<SMP) dan 58,0% memiliki jumlah saudara lebih dari > 3.

Kesimpulan: Insiden MRS lebih sering ditemukan pada anak perempuan, kelompok usia >5 tahun, malnutrisi sebelum masuk RS, mendapatkan nutrisi parenteral, memiliki orang tua dengan tingkat pendidikan rendah, jumlah saudara kandung > 3, serta memiliki diagnosis tunggal serta lama rawat > 7 hari. 

References

Campanozzi A, Russo M, Catucci A, et al. Hospital-acquired malnutrition in children with mild clinical conditions. Nutrition. 2009;25(5):540-547.

Rinninella E, Cintoni M, De Lorenzo A, Addolorato G, Vassallo G, Moroni R, et al. Risk, prevalence, and impact of hospital malnutrition in a Tertiary Care Referral University Hospital: a cross-sectional study. Intern Emerg Med. 2018;13(5):689-697.

Sidiartha IGL. Malnutrisi rumah sakit pada anak di rumah sakit umum pusat Sanglah, Denpasar. Dalam: Kumpulan Naskah Lengkap PIT IV IKA Medan 2010. Medan: Ikatan Dokter Anak Indonesia. 2010:56–65.

Sidiartha IGL. Insidens Malnutrisi Rumah Sakit Pada Anak Di Rumah Sakit Umum Pusat Sanglah Denpasar. Sari Pediatri. 2008;9(6):381-385.

Rocha GA, Rocha EJ, Martins CV. The effects of hospitalization on the nutritional status of children. J Pediatr (Rio J). 2006;82(1):70-74.

Waitzberg DL, Correia MI. Nutritional assessment in the hospitalized patient. Curr Opin Clin Nutr Metab Care. 2003;6(5):531-538.

Oken E, Lightdale JR. Updates in pediatric nutrition. Curr Opin Pediatr. 2000;12(3):282-290.

Mehta NM, Corkins MR, Lyman B, Malone A, Goday PS, Carney LN, et al. Defining pediatric malnutrition: a paradigm shift toward etiology-related definitions. JPEN J Parenter Enteral Nutr. 2013;37(4):460-481.

Kac G, Camacho-Dias P, Silva-Coutinho D, Silveira-Lopes R, Marins VV, Pinheiro AB. Length of stay is associated with incidence of in-hospital malnutrition in a group of low-income Brazilian children. Salud Publica Mex. 2000;42(5):407-412.

Sidiartha IGL, Pratiwi IGAPE. Implementation of STRONGkids in identify risk of malnutrition in government hospital. Int J Heal Sci. 2018;2(2):18–24.

Beser OF, Cokugras FC, Erkan T, Kutlu T, Yagci RV; TUHAMAR Study Group. Evaluation of malnutrition development risk in hospitalized children. Nutrition. 2018;48:40-47.

Maryani E, Prawirohartono EP, Nugroho S. Faktor Prediktor Malnutrisi Rumah Sakit pada Anak. Sari Pediatri. 2017;18(4):278-284.

Budiputri GL, Suryawan IWB, Dewi MR. Analisis faktor – faktor yang mempengaruhi kejadian Malnutrisi Rumah Sakit (MRS) pada pasien anak di Bangsal Kaswari, RSUD Wangaya, Bali, Indonesia. Intisari Sains Medis. 2020;11(2):680-685.

Miriawati, Irawan R, Hidayat B, Widjaya NA, Hanindita MH. Risk Factor of Hospital Malnutrition After Pediatric Nutrition Care Management. Heal Notions. 2021;5(1):23–28.

Wu BN, O'Sullivan AJ. Sex differences in energy metabolism need to be considered with lifestyle modifications in humans. J Nutr Metab. 2011;2011:391809.

Khan T, Khan REA, Raza MA. Gender Analysis of Malnutrition: A Case Study of School-Going Children in Bahawalpur. Asian Dev Policy Rev. 2015;3(2):29–48.

Quadros DRS, Kamenwa R, Akech S, Macharia WM. Hospital-acquired malnutrition in children at a tertiary care hospital. South African J Clin Nutr. 2018;31(1):8–13.

de Oliveira Meller F, Assunção MC, Schäfer AA, de Mola CL, Barros AJ, Dahly DL, et al. The influence of birth order and number of siblings on adolescent body composition: evidence from a Brazilian birth cohort study. Br J Nutr. 2015;114(1):118-25.

Jahanihashemi H, Noroozi M, Zavoshy R, Afkhamrezaei A, Jalilolghadr S, Esmailzadehha N. Malnutrition and birth related determinants among children in Qazvin, Iran. Eur J Public Health. 2017;27(3):559-562.

Vollmer S, Bommer C, Krishna A, Harttgen K, Subramanian SV. The association of parental education with childhood undernutrition in low- and middle-income countries: comparing the role of paternal and maternal education. Int J Epidemiol. 2017;46(1):312-323.

Khattak UK, Iqbal SP, Ghazanfar H. The Role of Parents' Literacy in Malnutrition of Children Under the Age of Five Years in a Semi-Urban Community of Pakistan: A Case-Control Study. Cureus. 2017;9(6):e1316.

Blaauw R, Achar E, Dolman RC, Harbron J, Moens M, Munyi F, Nyatefe D, Visser J. The Problem of Hospital Malnutrition in the African Continent. Nutrients. 2019;11(9):2028.

Abdelhadi RA, Bouma S, Bairdain S, Wolff J, Legro A, Plogsted S, et al. Characteristics of Hospitalized Children With a Diagnosis of Malnutrition: United States, 2010. JPEN J Parenter Enteral Nutr. 2016;40(5):623-635.

Casaer MP, Mesotten D, Hermans G, Wouters PJ, Schetz M, Meyfroidt G, et al. Early versus late parenteral nutrition in critically ill adults. N Engl J Med. 2011;365(6):506-517.

Ziegler TR. Parenteral nutrition in the critically ill patient. N Engl J Med. 2009;361(11):1088-1097.


No Supplementary Material available for this article.
Article Views      : 176
PDF Downloads : 83