Publication: Malnutrition in hospitalized pediatric patients: A comparison of the national Turkish and World Health Organization (WHO) child growth standards
Abstract
Amaç: Özellikle hastanede yatarak tedavi gören çocuklarda olmak üzere, malnütrisyonun önemli bir mortalite nedeni olduğu iyi bilinmektedir. Tüm dünyada malnütrisyonun tanımlanması açısından bir karmaşa söz konusu olduğundan, Dünya Sağlık Örgütü (DSÖ) z-skorlamasının kullanımını önermiş ve DSÖ büyüme standartlarının tüm ülkelerde geçerli olarak kullanılabileceğini bildirmiştir. Bu çalışmanın amacı, hastanede yatarak tedavi görmekte olan çocuk hastalarda malnütrisyon durumunu değerlendirmek ve Neyzi büyüme standartları ile DSÖ standartlarını karşılaştırmaktır. Hastalar ve Yöntem: Beş yaş altındaki hastalarda, ulusal Neyzi ve DSÖ 2006 standartlarına göre, yaşa-göre-ağırlık, boya-göre-ağırlık ve yaşa-göre-boy yüzdeleri ve z-skorları hesaplandı, <-2 SD olan değerler malnütrisyon olarak tanımlandı. Bulgular: Çalışmaya alınan 100 hastanın 62si erkek olup ortalama yaş 15,9±16,2 ay idi. Akut malnütrisyon %12, kronik malnütrisyon %13 ve tartı azlığı %11 olarak bulundu. Hesaplanan yaşa-göre-ağırlık ve yaşa-göre-boy z-skorları iki büyüme standartları arasında anlamlı olarak farklı bulundu (p<0,001). Sonuç: Yeni DSÖ büyüme standartlarının tüm ülkelerde kullanılabileceğine ilişkin DSÖ açıklamasına rağmen, DSÖ ile yerel büyüme eğrileri arasında varolan uyumsuzluk, malnütrisyonun değerlendirilmesinde büyük bir sorun oluşturmaktadır. (Marmara Üniversitesi Tıp Fakültesi Dergisi 2012;25:128-32)
Objective: Malnutrition is known to be responsible for mortality especially in hospitalized children. Since there is a controversy regarding the criteria used to define malnutrition worldwide, the World Health Organization (WHO) has recommended using z-scores and has reported that the WHO child growth standards have worldwide validity. The aims of this study were to evaluate the prevalence of malnutrition in hospitalized pediatric patients and compare the Neyzi growth standards used in Turkey with the WHO standards. Patients and Methods: Weight-for-age, weight-for-height, and height-for-age were calculated separately in patients under five years old using the national Neyzi standards and the WHO 2006 standards. The weight-for-age- and heightfor- age z-scores were also calculated, and malnutrition was defined as < -2 SD. Results: Among the 100 patients included in the study, 62 were male, and the mean age was 15.9±16.2 months. Twelve percent of the patients were classified as acute malnutrition, 13% were classified as chronic malnutrition, and 11% were underweight. The calculated mean weight-for-age and height-for-age z-scores were significantly different between the two growth standards (p<0.001). Conclusion: Although WHO has reported that the new WHO growth standards are applicable in all countries, there was a discrepancy between the WHO- and country-specific growth charts, and this presents a major problem for the evaluation of malnutrition. (Marmara Medical Journal 2012;25:128-32)
Objective: Malnutrition is known to be responsible for mortality especially in hospitalized children. Since there is a controversy regarding the criteria used to define malnutrition worldwide, the World Health Organization (WHO) has recommended using z-scores and has reported that the WHO child growth standards have worldwide validity. The aims of this study were to evaluate the prevalence of malnutrition in hospitalized pediatric patients and compare the Neyzi growth standards used in Turkey with the WHO standards. Patients and Methods: Weight-for-age, weight-for-height, and height-for-age were calculated separately in patients under five years old using the national Neyzi standards and the WHO 2006 standards. The weight-for-age- and heightfor- age z-scores were also calculated, and malnutrition was defined as < -2 SD. Results: Among the 100 patients included in the study, 62 were male, and the mean age was 15.9±16.2 months. Twelve percent of the patients were classified as acute malnutrition, 13% were classified as chronic malnutrition, and 11% were underweight. The calculated mean weight-for-age and height-for-age z-scores were significantly different between the two growth standards (p<0.001). Conclusion: Although WHO has reported that the new WHO growth standards are applicable in all countries, there was a discrepancy between the WHO- and country-specific growth charts, and this presents a major problem for the evaluation of malnutrition. (Marmara Medical Journal 2012;25:128-32)