Total Lymphocyte Count (TLC) sebagai Faktor Prediktor Malnutrisi Rumah Sakit pada Anak

Abstract

Background: Children are more vulnerable to malnutrition and their nutritional status often deteriorates during hospitalization which contributes negatively on patient outcomes. Although the prevalence of hospital-acquired malnutrition (HAM) is quite high, this condition is ignored and consequently, not treated. To prevent HAM, risk of nutritional status deterioration should be detected as soon as possible. Total lymphocyte count (TLC) is associated with impaired function of immune system in malnutrition and can be used as a predictor for HAM.

Objective: To evaluate the predictor value of TLC to the occurrence of HAM in pediatric patients.

Methods: This an observational study with a retrospective cohort design. This research was conducted at Adam Malik Hospital from March until April 2023. Subjects who met the inclusion and exclusion criteria were enrolled in the study. Subjects were assessed for weight at the first day of hospitalization and then followed until they were discharged. Body weight was re-measured on discharge to determine the presence of HAM. TLC was assessed on the first day of hospitalization. In this study, cut-off point of TLC used 3,000 cell/mm3.

Results: Among 41 subjects, 14 subjects or 34.1 % experienced HAM. Subjects with TLC< 3,000 cell/mm3 compared to TLC ≥ 3, 000 cell/mm3 had a 6.2-fold risk of experiencing hospital acquired malnutrition (RR: 7.11; 95% Confidence Interval: 1.45 to 34.72, p=0.024). In multivariate analysis, Length of stay and TLC were the risk factor for HAM in this research. Length of stay was the most dominant variable (RR: 7.11;95% Confidence Interval: 1.45 to 34.72, p=0.015).

Conclusion: This study proved that TLC< 3,000 cell/mm3 is the risk of HAM. Total lymphocyte count could be used as predictor of the risk of HAM in hospitalized children.

Keywords: hospital malnutrition, total lymphocyte, children