Improvements in body mass index of children with cystic fibrosis following implementation of a standardized nutritional algorithm: A quality improvement project

Yasemin Gokdemir; Ela Erdem Eralp; Almala Pinar Ergenekon; Cansu Yilmaz Yegit; Muruvvet Yanaz; Hakan Mursaloglu; Burcu Uzunoglu; Damla Kocamaz; Gamze Tastan; Amy Filbrun; Catherine Enochs; Sandra Bouma; Courtney Iwanicki; Fazilet Karakoc; Samya Z. Nasr; Bulent Karadag

doi:10.1002/ppul.26344

journal article Mar 21, 2023

Improvements in body mass index of children with cystic fibrosis following implementation of a standardized nutritional algorithm: A quality improvement project

Yasemin Gokdemir

Ela Erdem Eralp Almala Pinar Ergenekon

Cansu Yilmaz Yegit

Muruvvet Yanaz

Hakan Mursaloglu Burcu Uzunoglu Damla Kocamaz Gamze Tastan Amy Filbrun

Catherine Enochs

Sandra Bouma Courtney Iwanicki Fazilet Karakoc Samya Z. Nasr

Bulent Karadag

Pediatric Pulmonology Vol. 58 No. 5 pp. 1463-1470 · Wiley

View at Publisher Save 10.1002/ppul.26344

Abstract

AbstractBackgroundA collaboration between the University of Michigan (UM) Cystic Fibrosis Center (CFC) and Marmara University (MU) CFC was initiated in MU through conducting Quality Improvement projects (QIP). The global aim was to improve nutritional status of children with CF (cwCF), with a specific aim to increase the mean BMI percentile (BMIp) for cwCF by 10 percentile points in 12 months.MethodsBody mass index (BMI) percentiles of cwCF were categorized as: nutritionally adequate (BMIp ≥ 50%); at risk (BMIp 25%–49%); urgently at risk (BMIp 10%–25%); critically at risk (BMIp < 10%). Appropriate interventions were made according to BMIp category every three months. Forced expiratory volume in one‐second percent predicted (FEV1pp), and health‐related quality of life (HRQoL) were evaluated.ResultsOne hundred and eight‐two cwCF with a mean age of 9.1 ± 4.3 years were included in the project. Baseline BMIp increased from 25.6 to 37.2 at the 12th month (p < 0.001). In the critically at‐risk group BMIp increased from 3.6 to 20.5 (p < 0.001), in the urgently at risk group from 15.9 to 30.8 (p < 0.001), in the at risk group from 37.0 to 44.2 (p < 0.079) and in the nutritionally adequate group the increase was from 66.8 to 69.5 (p < 0.301). FEV1pp also improved significantly, from 81.3 ± 20.6 to 85.9 ± 20.8 (p < 0.001). Physical functioning, eating problems, and respiratory symptoms domains of the HRQoL evaluation improved (p < 0.05).ConclusionThis project has led to significant improvements in BMIp, FEV1pp and HRQoL of cwCF; similar projects could easily be implemented by centers in other developing countries.

Topics

No keywords indexed for this article. Browse by subject →

References

32

[1]

10.1016/j.jcf.2014.03.009

[2]

10.1093/intqhc/mzr017

[3]

10.1002/(sici)1099-0496(199910)28:4<242::aid-ppul2>3.0.co;2-w

[4]

10.1002/(sici)1099-0496(199910)28:4<248::aid-ppul3>3.0.co;2-n

[5]

10.1016/j.jpeds.2005.03.044

[6]

10.1016/j.jpeds.2005.06.027

[7]

Deming DE (1986)

[8]

10.1136/bmjqs-2013-002369

[9]

OrentiA ZolinA JungA et al. ECFSPR Annual Report.2022.

[10]

Patient‐Registry‐Annual‐Data‐Report.2021.

[11]

10.1186/s13023-017-0744-8

[12]

10.1002/ppul.23128

[13]

10.1002/ppul.26041

[14]

10.1002/ppul.20766

[15]

https://www.ceddcozum.com

[16]

Standardisation of spirometry

M. R. Miller, J. Hankinson, V. Brusasco et al.

European Respiratory Journal 10.1183/09031936.05.00034805

[17]

10.1164/rccm.200812-1845pp

[18]

10.1016/s1569-1993(07)60289-6

[19]

10.1002/ppul.21322

[20]

10.1002/ppul.21147

[21]

10.1542/peds.2004-2823

[22]

10.3390/nu13061801

[23]

10.1016/j.jpeds.2008.07.011

[24]

10.1002/ppul.23147

[25]

10.1002/ppul.25059

[26]

10.1016/j.jcf.2020.07.023

[27]

10.1002/ppul.21325

[28]

10.1186/1824-7288-40-50

[29]

Borawska‐Kowalczyk U "Determinants of health‐related quality of life in polish patients with CF ‐ adolescents' and parents' perspectives" Dev Period Med (2015)

[30]

10.1007/s11136-011-0100-8

[31]

Stein L "Health‐related quality of life and physical activity in children with cystic fibrosis" EC Pulmonol Respir Med (2017)

[32]

10.1016/j.jcf.2013.01.006

Cited By

5

Associations between income level and health outcomes in people with cystic fibrosis in Turkey

Neval Metin Cakar, Seyda Karabulut · 2025

Journal of Cystic Fibrosis

Metrics

5

Citations

32

References

Details

Published: Mar 21, 2023
Vol/Issue: 58(5)
Pages: 1463-1470
License: View

Authors

Y

Yasemin Gokdemir

Division of Pediatric Pulmonology Marmara University School of Medicine Istanbul Turkey

E

Ela Erdem Eralp

Division of Pediatric Pulmonology Marmara University School of Medicine Istanbul Turkey

A

Almala Pinar Ergenekon

Division of Pediatric Pulmonology Marmara University School of Medicine Istanbul Turkey

C

Cansu Yilmaz Yegit

Division of Pediatric Pulmonology Marmara University School of Medicine Istanbul Turkey

M

Muruvvet Yanaz

Division of Pediatric Pulmonology Marmara University School of Medicine Istanbul Turkey

H

Hakan Mursaloglu

Department of Emergency Medicine King's College Hospital London UK; Marmara University School of Medicine Selim Coremen Cystic Fibrosis Center Istanbul Turkey

B

Burcu Uzunoglu

Marmara University School of Medicine Selim Coremen Cystic Fibrosis Center Istanbul Turkey

D

Damla Kocamaz

Marmara University School of Medicine Selim Coremen Cystic Fibrosis Center Istanbul Turkey

G

Gamze Tastan

Marmara University School of Medicine Selim Coremen Cystic Fibrosis Center Istanbul Turkey

A

Amy Filbrun

Division of Pediatric Pulmonology University of Michigan Ann Arbor Michigan USA

C

Catherine Enochs

Division of Pediatric Pulmonology University of Michigan Ann Arbor Michigan USA

S

Sandra Bouma

Division of Pediatric Pulmonology University of Michigan Ann Arbor Michigan USA

C

Courtney Iwanicki

Division of Pediatric Pulmonology University of Michigan Ann Arbor Michigan USA

F

Fazilet Karakoc

Division of Pediatric Pulmonology Marmara University School of Medicine Istanbul Turkey

S

Samya Z. Nasr

Division of Pediatric Pulmonology University of Michigan Ann Arbor Michigan USA

B

Bulent Karadag

Division of Pediatric Pulmonology Marmara University School of Medicine Istanbul Turkey

Cite This Article

Yasemin Gokdemir, Ela Erdem Eralp, Almala Pinar Ergenekon, et al. (2023). Improvements in body mass index of children with cystic fibrosis following implementation of a standardized nutritional algorithm: A quality improvement project. Pediatric Pulmonology, 58(5), 1463-1470. https://doi.org/10.1002/ppul.26344

Improvements in body mass index of children with cystic fibrosis following implementation of a standardized nutritional algorithm: A quality improvement project

You May Also Like