Simple measures can predict death in malnourished children
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《英国医生杂志》
A doctor checks for signs of malnourishment by measuring arm circumference at a clinic in Mogadishu, Somalia
Credit: PEP BONET/PANOS
Mid-upper arm circumference predicts risk of death in malnourished children as well as the currently recommended weight for height z score. A study in rural Kenya has found that the simple measure could provide a more practical way to identify children at high risk ( JAMA 2005;294: 591-7).
The study compared mid-upper arm circumference and visible severe wasting muscle loss among more than 8000 malnourished children in rural Kenya. In all, 4.4% (359) of children included in the study died while in the hospital. Mid-upper arm circumference and visible severe wasting proved to be as useful in predicting death as weight for height z score.
The lead author of the study, James Berkley, from Kenya Medical Institute Centre for Geographic Medicine Research, Kilifi, Kenya, said, "Even though severe malnutrition is a major cause of death among many hospitalised children in sub-Saharan Africa, the current recommended assessment method using weight for height to determine if a child is malnourished is not always feasible in these clinical settings."
Dr Berkley noted that recent reports have indicated problems in initially identifying severely malnourished children at admission to hospital. Calculating the weight for height z score depends on correctly recording weight and height values and then looking up a third value on a chart, which must be readily available.
"Height is difficult to measure accurately in children at any time but especially so in a busy ward and when children are ill or distressed. The measurement of weight depends on the presence of properly calibrated and functioning scales, which often are not available," he said. See p369.(Susan Mayor)
Credit: PEP BONET/PANOS
Mid-upper arm circumference predicts risk of death in malnourished children as well as the currently recommended weight for height z score. A study in rural Kenya has found that the simple measure could provide a more practical way to identify children at high risk ( JAMA 2005;294: 591-7).
The study compared mid-upper arm circumference and visible severe wasting muscle loss among more than 8000 malnourished children in rural Kenya. In all, 4.4% (359) of children included in the study died while in the hospital. Mid-upper arm circumference and visible severe wasting proved to be as useful in predicting death as weight for height z score.
The lead author of the study, James Berkley, from Kenya Medical Institute Centre for Geographic Medicine Research, Kilifi, Kenya, said, "Even though severe malnutrition is a major cause of death among many hospitalised children in sub-Saharan Africa, the current recommended assessment method using weight for height to determine if a child is malnourished is not always feasible in these clinical settings."
Dr Berkley noted that recent reports have indicated problems in initially identifying severely malnourished children at admission to hospital. Calculating the weight for height z score depends on correctly recording weight and height values and then looking up a third value on a chart, which must be readily available.
"Height is difficult to measure accurately in children at any time but especially so in a busy ward and when children are ill or distressed. The measurement of weight depends on the presence of properly calibrated and functioning scales, which often are not available," he said. See p369.(Susan Mayor)