Predictors of Malnutrition in Children with Cystic Fibrosis

ABSTRACT

Objective: To determine occurrence of malnutrition in childrenwith cystic fibrosis and identify predictors of malnutrition at time ofenrolment and after 2 years of follow up.Design: Retrospective chart review.Setting: Pediatric chest clinic at a tertiary-care center in northernIndia.Patients Cystic fibrosis patients enrolled between 2009-2015with at least 3 years follow-up.Procedure Weight and height were noted at enrolment, and after1 year and 2 years of follow-up. Clinical details, medications, andpulmonary exacerbations during second year were recorded.Main outcome measure: Occurrence of malnutrition i.e. weightfor age Z-score < -2.Results: 61 medical records were reviewed. Occurrence ofmalnutrition at baseline, and 1- and 2-year follow-up was 65.5%,54.1% and 57.3%, respectively. Weight for age Z-score atenrolment significantly correlated with time to diagnosis fromonset r=0.015, P=0.029). Weight for age Z-score at 2-year follow-up was significantly associated with steatorrhea (P=0.03),increased frequency of stools (P<0.01) and pulmonaryexacerbation (P=0.03) during second year. Linear regressionshowed significant association between weight for age Z-score at2 years with steatorrhea and pulmonary exacerbations [r=-0.795(-1.527, -0.062)] and [r=-0.261 (-0.493, -0.028)]. Pulmonaryexacerbations during second and third year had significantcorrelation with weight for age Z-score at the beginning ofrespective years (r = -0.219, P=0.015).Conclusion: Occurrence of malnutrition is high in children withcystic fibrosis in this region, with uncontrolled fat malabsorptionand recurrent respiratory infections being significant risk factors.