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Measuring malnutrition and its impact on pediatric surgery outcomes: A NSQIP-P analysis

Mya L Roberson1, Matthew D Egberg2, Paula D Strassle3

  • 1Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC.

Journal of Pediatric Surgery
|November 16, 2020
PubMed

Insights

Pediatric malnutrition indicators like nutritional support, stunting, and hypoalbuminemia increase post-operative infection risk. Wasting did not show a significant association with infection outcomes.

Area of Science:

  • Pediatric Surgery
  • Nutritional Science
  • Public Health

Background:

  • Limited understanding of how pediatric malnutrition indicators affect surgical outcomes.
  • Malnutrition is prevalent in pediatric surgical populations.
  • Identifying key indicators is crucial for improving patient care.

Purpose of the Study:

  • To investigate the association between various pediatric malnutrition indicators and 30-day post-operative infection.
  • To determine if specific malnutrition definitions impact surgical outcomes.
  • To inform risk stratification and patient optimization strategies.

Main Methods:

  • Analysis of the ACS NSQIP-Pediatric database (2016-2018).
  • Inclusion of 282,056 pediatric surgical patients.
  • Multivariable logistic regression to assess odds of post-operative infection based on malnutrition definitions (stunting, wasting, nutritional support, hypoalbuminemia).

Main Results:

  • 19% of patients met one malnutrition definition, 6% met two.
  • Requiring nutritional support (OR 1.47), stunting (OR 1.17), and hypoalbuminemia (OR 1.17) were linked to higher infection odds.
  • Requiring nutritional support also increased time to surgery by over 10 days.

Conclusions:

  • The definition of malnutrition influences its association with post-operative outcomes.
  • Nutritional support, stunting, and hypoalbuminemia are associated with poorer outcomes.
  • Findings support improved pre-operative counseling, risk assessment, and surgical planning for pediatric patients.
Abstract

Keywords:
MalnutritionOutcomesSurgical site infections

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