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- W4313220590 abstract "Introduction: Malnutrition affects up to 51% of the PICU population and is associated with adverse outcomes. The nutritional needs of critically ill children with neurologic injury are unknown. The study hypothesis is that malnutrition is prevalent and associated with worse outcomes. Methods: Retrospective cohort study of children admitted (index) to Neuro ICU with medical and surgical primary diagnosis between 01-2019 to 12-2021. Underweight assessed by WHO and CDC weight for age charts (WFA z score < -2). Comparison by Mann-Whitney and Chi-Square as appropriate. Results: A total of 1112 patients were enrolled (45% females). The median (IQR) was for age 6.7(1.9-13) yrs., weight 22 (12-45) kg, ICU length of stay (LOS) 1.9 (1.05-4) days, hospital LOS 5.7 (3.5-15) days, mechanical ventilation (MV) duration (n= 35%) 51 (20-153) hours, PIM3 risk of mortality (ROM) 0.7 (0.4-1.5) %. The prevalence of underweight was 12% and mortality was 1.7%. Diagnostic categories included: seizures (36%), Neurovascular (18%), Infections (13%), Neuromuscular (2%), spinal cord (3%), encephalopathy (11%), increased ICP (10%), extrapyramidal (3%), neuro-degenerative disorder (3%), complications (2%), traumatic (4%). Comparing surgical (24%) vs medical (76%) patients; age: 8.5(3.6-14) vs 6 (1.6-12.5) yrs. (p < 0.0001); PIM3 ROM: 0.32(0.1-0.9) vs 0.80 (0.6-2) % (p < 0.0001); MV duration: 44 (21-136) vs 52 (20-161) hours (p=0.5); ICU LOS: 1.46 (1-3.09) vs 2.07 (1.2-4.3) days (p < 0.0001); Hospital LOS: 6.6 (3.7-16) vs 5.6 (3-14.7) days (p=0.08); underweight: 9.4% vs 13% (p=0.12); mortality: 1.1 % vs 1.9% (p=0.4). Comparing underweight (24%) vs non-underweight (76%) patients; age was 8.9 (1-14) vs 6.6(2-12.7) yrs. (p=0.8); PIM3 ROM: 0.79(0.45-1.79) vs 0.7 (0.32-1.4) % (p=0.1); MV duration: 98 (31-229) vs 47 (20-139) hours (p=0.006); ICU LOS: 2.9 (1.2-7) vs 2 (1-3.9) days (p=0.0008); Hospital LOS: 6.6 (3.7-17.6) vs 5.6 (3.4-14.7) days (p =0.13); mortality: 3.7% vs 1.43% (p=0.056). Conclusions: Malnutrition was prevalent in the Neuro pediatric ICU population with a higher prevalence in medical patients. Medical patients compared to surgical, were younger and underweight, had a higher risk of mortality and prolonged ICU LOS. Underweight patients were associated with increased mechanical ventilation and ICU length of stay." @default.
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- W4313220590 date "2022-12-15" @default.
- W4313220590 modified "2023-09-27" @default.
- W4313220590 title "324: UNDERWEIGHT AND OUTCOMES IN SURGICAL AND MEDICAL CRITICALLY ILL CHILDREN ADMITTED TO THE NEURO-ICU" @default.
- W4313220590 doi "https://doi.org/10.1097/01.ccm.0000907028.98835.ed" @default.
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