Complications and Comorbidities in Hospitalized Children with Severe Acute Malnutrition

Abstract

Background: Severe Acute Malnutrition (SAM) remains a major cause of childhood morbidity and mortality in low- and middle-income countries, including India. Hospitalized children with SAM often present with multiple comorbidities and life-threatening complications, which significantly influence outcomes. Objectives: To evaluate the incidence, clinical profile, comorbidities, complications, and early outcomes among hospitalized children with Severe Acute Malnutrition. Methods: A hospital-based observational analytical study was conducted over one year at the Nutrition Rehabilitation Centre (NRC), Civil Hospital, Ahmedabad. Children aged 6–59 months fulfilling WHO criteria for SAM were enrolled. Sociodemographic details, feeding practices, anthropometry, clinical features, laboratory parameters, comorbidities, complications, duration of hospital stay, and outcomes were recorded and analyzed. Results: Out of 7,566 children screened, 211 (2.79%) were diagnosed with SAM. The majority were below two years of age (65%) and belonged to lower socioeconomic strata (55.92%). Inadequate exclusive breastfeeding was observed in 56.4% of children. Wasting and stunting were present in 70.14% and 49.28% respectively, with all children having MUAC <11.5 cm. Common comorbidities included nutritional anemia (73.93%), gastroenteritis (45.49%), pneumonia (29.85%), and septicemia (32.22%). Frequent complications were dehydration (48.34%), respiratory distress (39.81%), hypothermia (30.80%), and septic shock (18.95%). The mortality rate was 9.48%. Conclusion: Severe Acute Malnutrition continues to impose a substantial clinical burden among hospitalized children. Early identification, optimal feeding practices, timely management of infections, and comprehensive inpatient care are essential to reduce morbidity and mortality.