Impact of Malnutrition on Morbidity and Paediatric Risk of Mortality Score among Critically-ill Children: A Prospective Observational Study

Introduction: Malnutrition among critically ill children admitted to the Paediatric Intensive Care Unit (PICU) continues to be a serious health concern, particularly in developing nations where the prevalence of malnutrition is disproportionately high. Malnourished children have weak immune system. This leads to higher chances of mortality and morbidity in such children. Aim: To evaluate the impact of malnutrition on mortality and morbidity in critically ill children who were admitted to PICU in a hospital in Navi Mumbai. Materials and Methods: The present prospective observational study was conducted in the PICU of the Dr. D. Y. Patil, Nerul Hospital from October 2022 to November 2023. Study included 144 children aged between 1 and 12 months who were admitted in the PICU of the institution. Anthropometric measurements based on World Health Organisation (WHO) growth standards were used to evaluate nutritional status. PRISM 3 scores were established within the initial 24 hours of admission. Clinical variables and outcomes with respect to their nutrition, mortality, PICU stay and ventilation duration was compared. IBM Statistical Package for Social Sciences (SPSS) Statistics 26.0 was used to analyse the data, and a p-value of less than 0.05 was deemed statistically significant. Results: The study population’s mean age was 4.13±3.65 years, with 45.1% of participants being female and 54.9% being male. Using Odd’s ratio, severe malnutrition in children under five-yearold was significantly linked to an increased risk of death (OR=11.4, p=0.004) and the need for ventilation (OR=17.3, p<0.001). Severe thinness was associated with a significant increase in the odds of ventilation (OR=24.0, p=0.015) and prolonged PICU stay (OR=37.5, p=0.008) in children older than five years. In both age groups, there was no significant difference in PRISM 3 scores between nutritional groups (p=0.442 and p=0.910, respectively). Conclusion: In critically ill children, severe malnutrition and thinness are powerful indicators of negative outcomes like higher mortality, the need for ventilation, and lengthier PICU stays. In PICU settings, improving prognosis and lowering complications requires early nutritional assessment and focused intervention.