Chronic Malnutrition Increases the Risk of Nosocomial Infections in Pediatric Burn Patients: A Retrospective Cohort from the National Institute of Child Health.

Abstract

We aimed to evaluate the association between chronic malnutrition and nosocomial infections in pediatric patients with burns and controlled sociodemographic and clinical variables. We conducted a retrospective observational cohort study in the Pediatric Burn Care Unit of the National Institute of Child Health in Peru. Patients were selected using stratified probability sampling with an annual proportional allocation. The exposure variable was chronic malnutrition according to the World Health Organization (WHO) definition, and the response variable was nosocomial infection. We used generalized linear Poisson models with robust standard errors. The relative risk (RR) and 95% confidence intervals (95% CI) of the crude model and of models adjusted for statistical criteria (aRR1) and epidemiological criteria (aRR2) were estimated. Of the 170 patients included in the study, 35% had chronic malnutrition, and the cumulative incidence of nosocomial infection was 22.3%. The frequency of nosocomial infections was 40% in the patients with chronic malnutrition and 12.7% in the normonourished patients. The model results were as follows: crude model (RR: 3.14, 95% CI: 1.75-5.61, p<0,001), statistically adjusted model (aRR1: 2.88, 95% CI: 1.63-5.09, p<0.001), and epidemiologically adjusted model (aRR2: 3.19, 95% CI: 1.71-5.93, p<0.001). Chronic malnutrition increases the risk of nosocomial infections in pediatric patients with burns independent of the demographic and clinical variables measured.