同济大学学报（医学版）2025，Vol.46Issue(6)：857-864,8.DOI:10.12289/j.issn.2097-4345.25078
肺炎住院学龄儿童营养情况与再入院风险的关系研究
Study on the relationship between nutritional status and readmission risk among children of school age hospitalized with pneumonia
摘要
Abstract
Objective To explore the impact of nutritional status on the risk of readmission among hospitalized children with pneumonia after discharge and to propose countermeasures and recommendations.Methods A total of 8 817 children aged 6-18 years who were first hospitalized for community-acquired pneumonia from 2017 to 2024 at Shanghai Children's Hospital were enrolled according to the inclusion and exclusion criteria in this study.Data on pneumonia hospitalizations,height,weight,and readmission status after discharge were retrieved from the hospital's electronic medical record system.Nutritional status was classified based on body mass index(BMI)using the WS/T 456 and WS/T 586 nutritional screening templates compiled in Excel.The SPSS was used to describe and stratify the distribution of nutritional screening results.A multivariate COX regression model was employed to analyze the association and strength between nutritional status and cumulative readmission rates within one year or 30 days after discharge for both mild and severe pneumonia,controlling for confounding factors such as gender,age,and region.Results The average age of children first hospitalized for pneumonia was(8.47±2.02)years.The nutritional status distribution was as follows:61.4％normal,16.7％wasted,and 21.9％overweight or obese.Mild pneumonia accounted for 83.6％of cases,while severe pneumonia accounted for 16.4％.Among children hospitalized for severe pneumonia for the first time,the one-year readmission rates was 9.6％and 10.1％in the wasting and overweight/obesity groups respectively,significantly higher than the 5.4％in the normal nutrition group.The 30-day readmission rate in the overweight/obesity group(5.1％)was also notably higher than the 2.6％observed in the normal nutrition group.After controlled for gender,age and residential area,the COX regression analysis revealed that the adjusted risk ratios(RR)for one-year readmission were 1.777 for wasting and 1.966 for overweight/obesity children when compared to that in the normal nutrition group.The RR for 30-day readmission in the overweight/obesity group was 2.052.All these differences demonstrated statistical significance(all P＜0.05).Conclusion Compared to children with normal nutrition,wasting and overweight/obesity are associated with an increased readmission rate after pneumonia discharge.It is recommended to strengthen nutritional screening for children,promote nutritional screening for hospitalized pneumonia children,enhance nutritional interventions,encourage influenza vaccination,and focus on improving dietary patterns and lifestyle behaviors,particularly for wasted and overweight/obese children.关键词
肺炎/儿童/学生/营养/重复住院Key words
pneumonia/children/student/nutrition/readmission分类
医药卫生引用本文复制引用
周丽,王淼,周书雯,金泽妍,胡巧珍,陈科..肺炎住院学龄儿童营养情况与再入院风险的关系研究[J].同济大学学报（医学版）,2025,46(6):857-864,8.基金项目
上海申康医院发展中心市级医院小儿内科专科联盟项目(SHDC22024307-B) （SHDC22024307-B）
