Telemedicine follow-up and nutritional outcomes in children with neurological impairment: a longitudinal study.

Background: Children with neurological impairment are at high risk of malnutrition and require regular nutritional monitoring. Telemedicine has been increasingly used to support follow-up visits, but its impact on nutritional outcomes remains unclear. Methods: We conducted a longitudinal observational study including 152 children with neurological impairment. Patients received either standard in-person follow-up or a combination of in-person and telemedicine visits. Nutritional status was assessed using body mass index (BMI) z-score at baseline and follow-up. Nutritional outcome was classified as improved, stable, or worsened based on changes in BMI z-score. The aim of this study was to evaluate the association between telemedicine follow-up and nutritional outcomes and to identify clinical factors associated with nutritional worsening. Multivariable logistic regression was performed to identify predictors of nutritional deterioration. Results: At baseline, children in the telemedicine group were younger and had a higher prevalence of percutaneous endoscopic gastrostomy (PEG) ( Conclusion: Baseline BMI z-score was the only variable independently associated with nutritional worsening during follow-up. No statistically significant differences in nutritional outcomes were observed between telemedicine and standard care groups; however, differences in baseline characteristics limit direct comparability. Telemedicine may represent a feasible and complementary approach to support follow-up in nutritionally vulnerable pediatric patients.