Low Sodium and Albumin Level: Its Association with Outcome of Severe

Acute Malnutrition (SAM) Management at RSUP dr. Mohammad Hoesin

Palembang

Ika Dian Puspitanza, Moretta Damayanti, Julius Anzar

Department of Child Health, Faculty of Medicine Universitas Sriwijaya, Mohammad Hoesin
General Hospital, Palembang

Abstract

Background
Successful management of severe acute malnutrition (SAM) may be influenced by many
factors, including abnormal laboratory findings in the early phase of hospitalization. Previous
studies showed that exceptional laboratory results, such as anaemia, leukopenia, electrolytes
imbalance and acidosis, in association with SAM outcomes, varied.

Objective
To analyse the association between laboratory profiles at the beginning of hospitalization and
outcome of SAM management at RSUP dr. Mohammad Hoesin Palembang (RSMH).

Methods
It was a cross-sectional study reviewing medical records of SAM patients hospitalized
between July 2020 until June 2021. The outcomes were mortality rate and mean weight gain
during treatment categorized as insufficient (<5 g/kg/day) and sufficient (≥5 g/kg/day).

Results
There were 146 subjects with median age 33 (1-215) months and median length of stay 13 (1-
42) days. Haematology profiles showed anaemia in 44.5%, leukopenia 12.3%, leukocytosis
44.5%, thrombocytopenia 21.9% and thrombocytosis 21.9%. Elevated C-reactive protein and
hypoalbuminemia were identified in 38.4% and 17.8%, respectively. Electrolyte profiles
revealed hyponatremia in 23.3%, hypokalemia 15.1%, hypomagnesemia 1.4% and
hypophosphatemia 6.2%. The mortality was 8.9% and significantly associated with
hyponatremia (P=0.04; OR 3.58; 95%CI 1.06-12.07) and hypoalbuminemia (P=0.03; OR
3.70; 95%CI 1.07-12.78). The median weight gain was 3.59 (-12.6-31.75) g/kg/day and
showed no relationship with any laboratory profiles.

Conclusion
Haematology and electrolytes abnormalities are common in SAM patients, as in this study
where hyponatremia and hypoalbuminemia are significant factors for the mortality.

Keywords: Hyponatremia, Hypoalbuminemia, Mortality, Severe acute malnutrition.