Analisis Faktor-Faktor yang Memengaruhi Kejadian Malnutrisi Rumah Sakit pada Anak di Ruang Rawat Inap Anak RSUP H Adam Malik Medan

Abstract

Background. Hospital malnutrition (MRS) is a condition where children do not receive adequate nutritional support characterized by weight loss while hospitalized. Several factors such as illness, changes in the hospital environment, some medical procedures and stress due to being away from family can cause MRS. Globally, around 13-69% of children experience MRS and in Indonesia alone it is reported to be around 11.7-40.9%. Despite the high incidence of hospital malnutrition in children, many pediatricians and health workers are still unable to recognize MRS. Malnutrition risk screening in the form of screening tool risk on nutritional status and growth (STRONGkids) as one of the implementation of services for patients in accordance with international hospital accreditation standards has been carried out in recent years. However, the latest data report on the factors that influence and cause MRS in children is still high at H. Adam Malik Hospital Medan. Objective. To analyze the relationship of factors affecting the incidence of hospital malnutrition in pediatric patients in the pediatric inpatient room of H. Adam Malik Hospital Medan. Methods. The type of research conducted was an observational analytic study with a prospective cohort design in 63 patients aged 1 month to 18 years with 16 MRS and 47 not. Samples were taken by consecutive sampling method that met the inclusion and exclusion criteria in the pediatric inpatient unit (Rindu B4) of H. Adam Malik Hospital Medan with the consent of parents or guardians. Patients were screened with the STRONGkids questionnaire in the first 24-48 hours or at least 72 hours of treatment. Results. Several factors such as age, gender, nutritional status, underlying disease, and length of hospitalization (≥7 days and <7 days) were associated with MRS. There were 29 patients with hospitalization ≥7 days with 44.8% of them having MRS and <7 days with only 8.8% having MRS. The mean and median age of patients was younger in MRS than those without and the number of genders was similar between the two. There was a statistically significant association based on length of hospitalization compared to other factors. (p=0.001) (95%CI=5.080). Conclusion. Most of the characteristics of pediatric subjects admitted to the pediatric ward showed good nutritional status. The prevalence of hospital malnutrition at H. Adam Malik Hospital Medan has decreased from previous studies. Based on the assessment of malnutrition based on the STRONGkids method, most children showed a moderate risk level. There is a significant relationship between the length of stay factor and hospital malnutrition.