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Postoperative complications in the pediatric population. Malnutrition or phase angle? Which one do we use?

María José Díaz-Amaya1, Laura Fernanda Rosales-Arreola1,2, Jennifer Hernández-Licona1

  • 1Translational Research Center, Instituto Nacional de Pediatría, Mexico City, Mexico.

Frontiers in Nutrition
|October 23, 2024
PubMed

Insights

Pediatric surgical patients

Area of Science:

  • Pediatric surgery
  • Nutritional assessment
  • Bioimpedance analysis

Background:

  • Malnutrition elevates post-surgical risks in children, including infections and extended hospital stays.
  • Assessing pediatric nutritional status pre-surgery is complex, necessitating tools like Body Mass Index (BMI) and phase angle.
  • Phase angle, a measure of body cell mass, is vital for evaluating pediatric health outcomes and surgical risk.

Purpose of the Study:

  • To investigate the correlation between nutritional status, phase angle, and postoperative complications in pediatric surgical patients.
  • To evaluate the utility of phase angle as a predictive marker for surgical outcomes in children.
  • To identify key nutritional indicators for assessing surgical risk in pediatric populations.

Main Methods:

  • A prospective study involving 391 pediatric patients (aged 3-17) undergoing major non-ambulatory surgery.
  • Data collected included anthropometric measurements (BMI z-scores), hand grip strength, dietary intake, and phase angle via bioimpedance.
  • Postoperative complications, surgical risks, and pre- and postoperative conditions were meticulously documented.

Main Results:

  • 13% of patients experienced at least one postoperative complication, with surgical site infections being most frequent.
  • Decreased phase angle correlated with increased length of stay (LOS) across all participants.
  • Malnutrition was a risk factor for complications in children ≤12 years (OR 3.86), while phase angle was protective in adolescents (OR 0.63).

Conclusions:

  • Nutritional status, indicated by BMI z-score, significantly associates with post-surgical complications in younger pediatric patients.
  • Phase angle serves as an independent protective factor against postoperative complications in adolescent surgical patients.
  • These findings highlight the importance of comprehensive nutritional assessment, including phase angle, for optimizing pediatric surgical care.
Abstract

Keywords:
body compositionmalnutritionpediatric surgeryphase anglepostoperative complications

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