Prospective Study of the Impact of Preoperative Nutrition on Postoperative Outcomes in Paediatric Surgery Using a...

Malnutrition is a significant concern in the hospitalized surgical cohort. Despite this there is no standardized scheme tailored for the pediatric surgical cohort. This study evaluated the feasibility to of the novel two-axis scheme to fill the lacunae in pediatric nutritional assessment.

The aim of this study is to study the effect of the preoperative nutritional status on the clinical outcomes.

This is a prospective, observational, and cohort study of all pediatric patients undergoing surgery at our center from January 2021 to September 2022. Preoperative anthropometry was measured and all subjects were classified using the two-axis scheme incorporating body mass index and height z-scores into nonoutliers or one of the four outlier groups: underweight short, underweight tall, overweight short, and overweight tall. All complications within 30 days postsurgery were recorded and graded by the Clavien-Dindo classification.

The study included a total of 827 patients who underwent 1022 surgeries, 70.5% being males. About 33% of the cohort was under 5 years of age. Overall incidence of complications was 10.1% with underweight short group having the highest (19.7%). Underweight short group had higher incidence of composite and healthcare-associated infections (P < 0.05) and higher odds of all types of complication in comparison to the nonoutliers. No significant relation was noted between the nutritional groups and the severity of the complication.

This study supported the predictive value and feasibility of this novel two-axis nutritional classification scheme in the pediatric surgical outcomes. The underweight short subjects are at higher risk of developing postoperative complications.