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Nutritional status of pediatric patients submitted to ostomy procedures
Emanuelle Tenório B N do Egito1, Alcinda de Queiroz Medeiros, Mônica Maria C Moraes
1Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brasil.
Insights
Children undergoing ostomy surgery often experience nutritional deficits, particularly those with ileostomies. This study highlights the need for nutritional support in pediatric surgical patients with intestinal ostomies.
Area of Science:
- Pediatric Surgery
- Nutritional Science
- Clinical Research
Background:
- Children undergoing ostomy surgery face risks of nutritional compromise.
- Assessing nutritional status is crucial for managing pediatric patients with intestinal ostomies.
Purpose of the Study:
- To evaluate the nutritional status of children who have undergone ostomy procedures for intestinal discharge.
- To identify differences in nutritional status between children with colostomies and ileostomies.
Main Methods:
- A descriptive case series included 30 children (up to 10 years) undergoing colostomy or ileostomy.
- Collected socioeconomic, clinical, anthropometric, and laboratorial data (hemoglobin, hematocrit).
- Nutritional status assessed using WHO standards for height/age, weight/age, BMI/age, and body composition indicators.
Main Results:
- All anthropometric indicators showed nutritional deficits, with 24.1% exhibiting short stature (height/age).
- Ileostomized patients had lower mean Z scores for anthropometric indicators, hemoglobin, and hematocrit compared to colostomized patients.
- Significant differences were observed in BMI/age Z score (p=0.016), hemoglobin (p=0.025), and hematocrit (p=0.023) between ileostomy and colostomy groups.
Conclusions:
- A significant frequency of nutritional deficit exists in children with ostomies, particularly indicated by the height/age index.
- Ileostomized children experienced greater nutritional deficits despite shorter ostomy duration, suggesting higher complication risks.
- Nutritional impairment is a considerable concern in pediatric ostomy patients, necessitating targeted interventions.
Objective:
To assess the nutritional status of children submitted to ostomy for intestinal discharge.
Methods:
A descriptive case series was carried out including 30 children aged up to ten years old submitted to colostomy or ileostomy at the pediatric surgery unit of Institute of Medicine Professor Fernando Figueira, Recife, Pernambuco. Socioeconomic, clinical, anthropometric, and laboratorial (hemoglobin and hematocrit) data were collected using a structured questionnaire. Nutritional status was determined based on anthropometric indicators (height/age, weight/age, and body mass index/age), which were stratified by gender, with World Health Organization standards as reference. Arm circumference and triceps skinfold were measured for the evaluation of body composition. Chest and head perimeters were measured on children aged up to five years-old. The Student's t-test was applied to compare two independent groups, considering p<0.05 as significant.
Results:
All anthropometric indicators revealed nutritional deficit, especially in the height/age index, which revealed a frequency of 24.1% of short statue. Patients submitted to ileostomy presented lower mean Z score of anthropometric indicators, hemoglobin, hematocrit and ostomy time in comparison to those submitted to colostomy, with significant differences only for the Z score of body mass index/age (p=0.016), hemoglobin (p=0.025), and hematocrit (p=0.023).
Conclusions:
There is a substantial frequency of nutritional deficit in the analyzed sample, especially based on the height/age index. Although ileostomized patients had less time of ostomy, they had higher nutritional deficit compared to the colostomized ones, likely due to greater risk of postoperative complications, with consequent nutritional impairment.
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