BACKGROUND: Malnutrition is common in children with CHD and is likely to place them at an increased risk for adverse surgical outcomes. We sought to evaluate the impact of preoperative malnutrition on outcomes after paediatric cardiac surgery. METHODS: We conducted a retrospective analysis of patients from age 0 to 5 years undergoing cardiac surgery at Seattle Children's Hospital from 2006 to 2015. We used regression modelling to examine the impact of malnutrition on surgical outcomes. RESULTS: We found a non-linear relationship between low height-for-age and weight-for-age z-scores and mortality after surgery. In the range of z-score ⩽-2, each additional unit decrease in height-for-age or weight-for-age z-score was associated with a 2.9 or 2.1% increased risk for mortality, respectively. Each unit decrease in height-for-age z-score was associated with a 1.2% increased risk for cardiac arrest, 1.1% increased risk for infection, and an average of 1.7 additional hours of mechanical ventilation, 6 hours longer ICU stay, and 13 hours longer hospital stay. Each unit decrease in weight-for-age z-score was associated with a 0.7% increased risk for cardiac arrest, 0.8% increased risk for infection, and an average of 1.9 additional hours of mechanical ventilation and 5.3 additional hours of ICU stay. CONCLUSIONS: This study is unique in demonstrating a significant association between malnutrition and 30-day mortality and other adverse outcomes after paediatric cardiac surgery in a mixed population of CHD patients. By evaluating nutritional status as a continuous variable, we were able to clearly distinguish the point at which malnutrition begins to affect mortality.
BACKGROUND:Malnutrition is common in children with CHD and is likely to place them at an increased risk for adverse surgical outcomes. We sought to evaluate the impact of preoperative malnutrition on outcomes after paediatric cardiac surgery. METHODS: We conducted a retrospective analysis of patients from age 0 to 5 years undergoing cardiac surgery at Seattle Children's Hospital from 2006 to 2015. We used regression modelling to examine the impact of malnutrition on surgical outcomes. RESULTS: We found a non-linear relationship between low height-for-age and weight-for-age z-scores and mortality after surgery. In the range of z-score ⩽-2, each additional unit decrease in height-for-age or weight-for-age z-score was associated with a 2.9 or 2.1% increased risk for mortality, respectively. Each unit decrease in height-for-age z-score was associated with a 1.2% increased risk for cardiac arrest, 1.1% increased risk for infection, and an average of 1.7 additional hours of mechanical ventilation, 6 hours longer ICU stay, and 13 hours longer hospital stay. Each unit decrease in weight-for-age z-score was associated with a 0.7% increased risk for cardiac arrest, 0.8% increased risk for infection, and an average of 1.9 additional hours of mechanical ventilation and 5.3 additional hours of ICU stay. CONCLUSIONS: This study is unique in demonstrating a significant association between malnutrition and 30-day mortality and other adverse outcomes after paediatric cardiac surgery in a mixed population of CHD patients. By evaluating nutritional status as a continuous variable, we were able to clearly distinguish the point at which malnutrition begins to affect mortality.
Authors: Nilesh M Mehta; Mark R Corkins; Beth Lyman; Ainsley Malone; Praveen S Goday; Liesje Nieman Carney; Jessica L Monczka; Steven W Plogsted; W Frederick Schwenk Journal: JPEN J Parenter Enteral Nutr Date: 2013-03-25 Impact factor: 4.016
Authors: Bodil M K Larsen; Laksiri A Goonewardene; Catherine J Field; Ari R Joffe; John E Van Aerde; Dana Lee Olstad; Michael T Clandinin Journal: JPEN J Parenter Enteral Nutr Date: 2012-10-11 Impact factor: 4.016
Authors: Courtney R Schwalbe-Terilli; Diane H Hartman; Monica L Nagle; Paul R Gallagher; Richard F Ittenbach; Nancy B Burnham; J William Gaynor; Chitra Ravishankar Journal: Am J Crit Care Date: 2009-01 Impact factor: 2.228
Authors: Nilesh M Mehta; Lori J Bechard; Naomi Cahill; Miao Wang; Andrew Day; Christopher P Duggan; Daren K Heyland Journal: Crit Care Med Date: 2012-07 Impact factor: 7.598
Authors: Jia Yi Joel Lim; Rui Wen Bryan Wee; Mihir Gandhi; Yee Phong Lim; Li Nien Michelle Tan; Swee Chye Quek; Marion M Aw; Ching Kit Chen Journal: Front Cardiovasc Med Date: 2022-04-01
Authors: Luise V Marino; Mark J Johnson; Nigel J Hall; Natalie J Davies; Catherine S Kidd; M Lowri Daniels; Julia E Robinson; Trevor Richens; Tara Bharucha; Anne-Sophie E Darlington Journal: Cardiol Young Date: 2018-04-29 Impact factor: 1.093
Authors: David S Cooper; Kyle W Riggs; Farhan Zafar; Jeffrey P Jacobs; Kevin D Hill; Sara K Pasquali; Sara K Swanson; Sarah K Gelehrter; Amelia Wallace; Marshall L Jacobs; David L S Morales; Roosevelt Bryant Journal: J Am Heart Assoc Date: 2019-06-25 Impact factor: 5.501
Authors: Carey Yun Shan Lim; Joel Kian Boon Lim; Rajesh Babu Moorakonda; Chengsi Ong; Yee Hui Mok; John Carson Allen; Judith Ju-Ming Wong; Teng Hong Tan; Jan Hau Lee Journal: Front Pediatr Date: 2019-10-23 Impact factor: 3.418
Authors: Christina N Katsagoni; Olga Cheirakaki; Anastasia Hatzoglou; Ourania Zerva; Alexandra Koulieri; Konstantina Loizou; Emmanouela Vasileiadi; Maria Toilou; Kalliopi-Anna Poulia; Meropi D Kontogianni Journal: Nutrients Date: 2021-04-13 Impact factor: 5.717