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Epidemiol Health > Volume 44; 2022 > Article
Epidemiology and Health 2022;44: e2022047-0.
DOI: https://doi.org/10.4178/epih.e2022047    Published online May 16, 2022.
Epidemiological data on nutritional disorders and outcomes in hospitalized Thai children: an analysis of data from the National Health Database 2015-2019
Suchaorn Saengnipanthkul1  , Jeeraparn Phosuwattanakul2  , Kaewjai Thepsuthammarat3  , Nalinee Chongviriyaphan2 
1Division of Nutrition, Department of Pediatrics, Faculty of Medicine Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
2Division of Nutrition, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
3Epidemiology Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Correspondence  Suchaorn Saengnipanthkul ,Email: suchsa@kku.ac.th
Jeeraparn Phosuwattanakul ,Email: jeeraparn@yahoo.com
Received: Jan 11, 2022  Accepted after revision: May 16, 2022
Abstract
OBJECTIVES:
Malnutrition in hospitalized patients is a frequently overlooked health issue. We aimed to assess the prevalence and pattern of nutritional disorders in hospitalized Thai children from the National Health Database.
METHODS:
Hospitalized children aged 1 month to 18 years diagnosed with nutritional disorders between 2015 and 2019 were retrospectively reviewed using the National Health Security Office data. Based on the International Classification of Diseases, 10th revision, Clinical Modification, nutritional disorders were classified into 3 major forms of malnutrition: undernutrition (E40-E46), overweight and obesity (E66), and micronutrient deficiencies (D50-D53, E50-E56, E58, E60-E61, and E63).
RESULTS:
Out of 5,188,033 hospitalized children, malnutrition was identified in 115,254 (2.2%). Protein-energy malnutrition (PEM), overweight and obesity, and micronutrient deficiencies were prevalent in 0.21%, 0.27%, and 1.81%, respectively. Among those with micronutrient deficiencies, 95.0% had iron deficiency anemia, 2.2% had vitamin D deficiency, and 0.7% had zinc deficiency. Children aged under 5 years mostly had PEM, followed by iron deficiency anemia. Teenagers commonly had obesity and vitamin D deficiency. Patients with PEM who were admitted with common diseases had significantly longer hospital stays and higher hospital costs and mortality rates than those without PEM.
CONCLUSIONS:
Hospitalized children had various nutritional disorders, particularly PEM, which was associated with higher morbidity and mortality. Nutritional screening tools should be utilized for the early detection and treatment of malnutrition. Specific International Classification of Diseases codes for nutritional care services and intervention should be available. Additionally, nutritional interventions should be reimbursed, along with nutritional education and empowerment of healthcare providers, to improve hospital care service and improve patient outcomes.
Keywords: Children, Hospitalization, Malnutrition, Nutritional disorders, Prevalence
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