Nutritional status of children with severe forms of cerebral palsy undergoing surgical orthopedic treatment for spastic hip dislocation

Abstract

BACKGROUND:Protein-energy deficiency can affect the results and outcome of surgical treatment in children with cerebral palsy. An objective assessment of nutritional status before surgery can reduce the potential risk of complications by planning and adjusting the diet during treatment. AIM:The aim of this study is to assess the relationship of nutritional status with diet in children with severe forms of cerebral palsy who underwent surgical orthopedic treatment for spastic hip dislocations. MATERIALS AND METHODS:An observational, cross-sectional clinical study included 75 children with severe forms of cerebral palsy. Patients were divided into 2 groups — GMFCS IV and GMFCS V (Gross Motor Function Classification System).The nutritional status before surgery, the energy and nutritional value of the diet in the early postoperative period, the number of complications and the duration of hospitalization were assessed. RESULTS:51% (38/75) of children had problems with the safety and effectiveness of food intake, 24% (18/75) deficiency of body weight was detected, 33% (25/75) had a deficiency of muscle mass, all patients had a lack of body fat. The nutritional composition of the diet in the early postoperative period was 1.5–2.2 times lower than the age norm, covering 62% of the required daily calorie requirement and 50% in liquid. The potential risk of postoperative complications (95% CI) was: 0—3.9% in the total sample, 0—6.8% in the GMFCS IV group, and 0—8.6% in the GMFCS V group. CONCLUSIONS: 1. The preoperative nutritional status of patients with severe forms of cerebral palsy included in the study did not correspond to the parameters of children without neurological diseases and depended on the severity of motor disorders according to GMFCS. 2. Unbalanced nutrition in hospital conditions contributed to postoperative deficiency of nutrients, energy, fluid and required correction. 3. The potential risk of complications in the postoperative period in the examined children with severe forms of cerebral palsy and low trophological status ranged from 0 to 3.9 %.