Pediatric post-intensive care malnutrition—risk factors and their association with long-term functional outcomes 1 year after discharge: a retrospective cohort study in Thailand

Abstract

Background: Data on the long-term nutritional status of pediatric intensive care unit (PICU) survivors are limited, and the association with functional outcomes is unknown. The primary objectives were to determine the prevalence of post-intensive care malnutrition and its relationship with functional outcomes at 1 month and 1 year after PICU discharge. Methods: A retrospective chart review of all children aged 1 month to 15 years who were admitted to the PICU for >48 hours from July 2019 to January 2024 and had visits to the pediatric post-intensive care clinic at 1 month and 1 year after hospital discharge was conducted. Malnutrition was categorized using the body mass index according to the World Health Organization Growth Reference. Functional outcome was classified using the Pediatric Cerebral Performance Category. Results: A total of 129 children were included in the final analysis. Malnutrition was observed in 46 children (35.6%) at 1 month after discharge and in 29 children (22.5%) at 1 year after discharge. Children with baseline malnutrition were associated with malnutrition at both follow-up time points. Longer ventilator days were observed among children with malnutrition at both time points, and children who had malnutrition at 1 year had longer PICU stays. At least moderate dysfunction was associated with any malnutrition and wasting at 1 year after discharge, but not with overweight. Conclusions: Malnutrition was found in a substantial proportion of PICU survivors, with an association with poor long-term PCPC-related functional outcomes. Long-term nutritional follow-up and support should be warranted to optimize outcomes.