nutritional disorders
Protein Energy Undernutrition (PEU)
Prognosis for Protein Energy Undernutrition
In children, mortality varies from 5 to 40%. Mortality rates are lower in children with mild PEU and those given intensive care. Death in the first days of treatment is usually due to electrolyte deficits, sepsis, hypothermia, or heart failure. Impaired consciousness, jaundice, petechiae, hyponatremia, and persistent diarrhea are ominous signs. Resolution of apathy, edema, and anorexia is a favorable sign. Recovery is more rapid in kwashiorkor than in marasmus. Long-term effects of PEU in children are not fully documented. Some children develop chronic malabsorption and pancreatic insufficiency. In very young children, mild intellectual disability may develop and persist until at least school age. Permanent cognitive impairment may occur, depending on the duration, severity, and age at onset of PEU. In adults, PEU can result in morbidity and mortality (eg, progressive weight loss increases mortality rate for older patients in nursing homes). In older patients, PEU increases the risk of morbidity and mortality due to surgery, infections, or other disorders. Except when organ failure occurs, treatment is uniformly successful. 