Relationship between preoperative nutritional status and postoperative complications in pediatric surgical patients

Abstract

Abstract AIM: To determine the relationship between preoperative nutritional status and postoperative complications in pediatric surgical patients. METHODOLOGY: This prospective observational cohort study included 650 patients from 6 months to 18 years undergoing elective surgery at our institution. Nutritional status was standardized using Z-scores for weight, length, and BMI. Patients were monitored for a month following surgery to detect any complications, and they were classified into five grades using the Clavien-Dindo classification. The duration of hospital stays and readmission within 30 days following discharge were secondary outcomes. RESULTS: There were 627 patients of both sexes involved in the study: 350 patients aged six months to 5 years (Group A), while 277 were aged between 5- 18 years (Group B). Wasting status was 47.71% in Group A and 41.52% in Group B. In Group A, 40 % of patients were stunted, while 83.75 % were in Group B. Group A had 57.14 % underweight patients. The complication rate was 39.14 % in Group A and 38.99% in Group B. The incidence of postoperative complications was not significantly different in malnourished patients. The patients with prolonged duration of surgery (> 2 hours) developed more complications in both groups (Group A – 67.2%, Group B – 82.6%; p < 0.0001). Also, the patients who experienced complications had lengthier hospital stays (p < 0.001 in both groups) and increased readmission rates (p = 0.016 in Group A and p = 0.008 in Group B). CONCLUSION: In our study, Half of the patients in Group A and nearly 2/3rd in Group B were malnourished. The preoperative poor nutritional status based on anthropometric parameters is not associated with increased postoperative complications. Randomized control trials linking preoperative malnutrition based on anthropometric measures and clinical outcomes in pediatric surgery patients are necessary to provide more robust information on this subject.