21. NUTRITIONAL ASSESSMENT USING MILD UPPER ARM CIRCUMFERENCE IN VIET NAM NATIONAL CHILDREN’s HOSPITAL

Luu Thi My Thuc1, Doan Ngoc Anh1, Tran Thuy Linh2, Le Thi Kim Mai1, Nguyen Thi Hang Nga1
1 Vietnam National Children’s Hospital
2 Tam Anh General Hospital

Main Article Content

Abstract

Objective: To describe the nutritional status of hospitalized pediatric patients using anthropometric indicators and evaluate the correlation between mid upper arm circumference (MUAC z-score) and other anthropometric measures.


Methods: This retrospective cross-sectional study included 500 inpatients at Vietnam National Children’s Hospital from August 2021 to August 2022. Patients were categorized into four main clinical groups: severe illness, cachexia, fluid change, and acute conditions.


Results: The highest prevalence of malnutrition was observed in the cachexia group, with rates of underweight, stunting, wasting, and low MUAC being 50%, 50%, 25%, and 70.5%, respectively. Across all clinical groups, malnutrition was more frequently detected using MUAC z-score than weight-for-height. Malnourished children had a significantly longer hospital stay compared to well-nourished children (p < 0.05). The specificity of the MUAC z-score increased with the severity of malnutrition, from 68.6% in well-nourished children to 89.2% in those with severe malnutrition.


Conclusion: Children in the cachexia group had a higher prevalence of malnutrition than those with acute illness, fluid shifts, or severe conditions. It is recommended that multiple anthropometric indicators be used to assess nutritional status, particularly the MUAC z-score, which may improve detection accuracy in hospitalized children.

Article Details

References

[1] Abdelhadi R.A, 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): 623-35.
[2] Tổng cục thống kê. Niên giám thống kê, Nhà xuất bản Thống kê, 2019.
[3] Bùi N.L, Trần T.H, Vũ T.L và cộng sự. Một số yếu tố liên quan đến tình trạng suy dinh dưỡng ở bệnh nhi ung thư dưới 5 tuổi tại Bệnh viện Nhi Trung ương. Tạp chí Nghiên cứu và Thực hành Nhi khoa, 2021, 5 (1).
[4] Becker P, Carney L.N, Corkins M.R, Monczka J, Smith E, Smith S.E et al. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition). Nutr Clin Pract, 2015, 30 (1): 147-61.
[5] Pham Thị Thu Hương và cộng sự. Tình trạng dinh dưỡng của trẻ em nằm viện tại Bệnh viện Nhi Trung ương. Tạp chí Y học dự phòng, 2015 XXV (3), 163.
[6] Phạm Ngọc Toàn, Đỗ Tiến Sơn. Mô hình bệnh tật trẻ em tại một số bệnh viện huyện miền núi phía bắc. Tạp chí Y học Việt Nam, 2025, 549 (3), tr. 303-306.
[7] Cederholm T, Barazzoni R, Austin P, Ballmer P, Biolo G, Bischoff S.C et al. ESPEN guidelines on definitions and terminology of clinical nutrition. Clinical Nutrition, 2017, 36 (1): 49-64.
[8] Hecht C, Weber M, Grote V, Daskalou E, Dell’Era L, Flynn D et al. Disease associated malnutrition correlates with length of hospital stay in children. Clin Nutr, 2015, 34 (1): 53-9.
[9] Assefa B, Tadele H. Severe Acute Malnutrition among Unoperated Ethiopian Children with Congenital Heart Disease: A Wake-up Call to Reverse the Situation, A Retrospective Cross-Sectional Study. Ethiop J Health Sci, 2020, 30 (5): 707-14.
[10] Stephens K, Orlick M, Beattie S, Snell A, Munsterman K, Oladitan L et al. Examining Mid-Upper Arm Circumference Malnutrition z-score Thresholds. Nutrition in Clinical Practice, 2020, 35 (2): 344-52.