Clin Exp Pediatr.  2021 Sep;64(9):473-479. 10.3345/cep.2020.00458.

Impact of preoperative nutritional status on surgical outcomes in patients with pediatric gastrointestinal surgery

• Koofy NE
• Eldin HMN
• Mohamed W
• Gad M
• Tarek S
• Tagy GE

• KMID: 2519654
• DOI: http://doi.org/10.3345/cep.2020.00458

Abstract

Background
Malnutrition has a high incidence among pediatric surgical patients and contributes to increased risks of postoperative complications and extended hospital stays. Purpose: The present study aimed to determine the influence of preoperative nutritional status on the postoperative outcomes of pediatric patients who underwent elective gastrointestinal (GI) surgery.
Methods
This prospective observational study was conducted at Cairo University Specialized Pediatric Hospital. According to the designated inclusion criteria, 75 surgical cases of both sexes were included. A structured questionnaire was developed and administered. This questionnaire included 3 main sections: demographic data and nutritional status parameters at admission and discharge. Pre- and postoperative nutritional statuses were compared.
Results
According to both the subjective global nutritional assessment and STRONGKIDS score Questioner, more than 60% of patients in the upper GI patient group were at risk of malnutrition. Wasting status was most common in the upper GI patient group (67%; vs. 39.1% in the lower GI group). Underweight status was more common in the hepatobiliary and upper GI patient groups (nearly 50% for each group) than in the lower GI group (30.4%). On the other hand, stunted patients had a higher incidence of complications and a prolonged hospital stay (P=0.003 and P=0.037, respectively), while underweight lower GI patients experienced a prolonged hospital stay (P=0.02). A higher proportion of patients with preoperative anemia than those without preoperative anemia required a blood transfusion (P=0.003).
Conclusion
Nutritional assessment is a crucial component of pediatric surgical patient management. Both underweight and wasting statuses were more common among hepatobiliary and upper GI patients. Postoperative complications and a long hospital stay were more common among stunted patients.

Keyword

Nutritional assessment; Anthropometric measures; STRONGKIDS score; Postoperative complications; Pediatric gastrointestinal surgical patients