Koofy Nehal El, Eldin Hadeer Mohamed Nasr, Mohamed Wesam, Gad Mostafa, Tarek Sara, Tagy Gamal El
Cairo University, Pediatric Department, Cairo University Specialized Pediatric Hospital, Cairo, Egypt.
Pediatric Surgery Department, Cairo University Specialized Pediatric Hospital, Cairo, Egypt.
Clin Exp Pediatr. 2021 Sep;64(9):473-479. doi: 10.3345/cep.2020.00458. Epub 2020 Nov 16.
Malnutrition has a high incidence among pediatric surgical patients and contributes to increased risks of postoperative complications and extended hospital stays.
The present study aimed to determine the influence of preoperative nutritional status on the postoperative outcomes of pediatric patients who underwent elective gastrointestinal (GI) surgery.
This prospective observational study was conducted at Cairo University Specialized Pediatric Hospital. According to the designated inclusion criteria, 75 surgical cases of both sexes were included. A structured questionnaire was developed and administered. This questionnaire included 3 main sections: demographic data and nutritional status parameters at admission and discharge. Pre- and postoperative nutritional statuses were compared.
According to both the subjective global nutritional assessment and STRONGKIDS score Questioner, more than 60% of patients in the upper GI patient group were at risk of malnutrition. Wasting status was most common in the upper GI patient group (67%; vs. 39.1% in the lower GI group). Underweight status was more common in the hepatobiliary and upper GI patient groups (nearly 50% for each group) than in the lower GI group (30.4%). On the other hand, stunted patients had a higher incidence of complications and a prolonged hospital stay (P=0.003 and P=0.037, respectively), while underweight lower GI patients experienced a prolonged hospital stay (P=0.02). A higher proportion of patients with preoperative anemia than those without preoperative anemia required a blood transfusion (P=0.003).
Nutritional assessment is a crucial component of pediatric surgical patient management. Both underweight and wasting statuses were more common among hepatobiliary and upper GI patients. Postoperative complications and a long hospital stay were more common among stunted patients.
营养不良在小儿外科患者中发病率较高，会增加术后并发症风险及延长住院时间。
本研究旨在确定术前营养状况对接受择期胃肠（GI）手术的小儿患者术后结局的影响。
本前瞻性观察性研究在开罗大学专科医院儿科进行。根据指定的纳入标准，纳入75例男女手术病例。编制并实施了一份结构化问卷。该问卷包括3个主要部分：入院和出院时的人口统计学数据及营养状况参数。比较术前和术后营养状况。
根据主观全面营养评估和STRONGKIDS评分问卷，上消化道患者组中超过60%的患者存在营养不良风险。消瘦状况在上消化道患者组中最为常见（67%；而下消化道组为39.1%）。体重不足状况在肝胆和上消化道患者组中（每组近50%）比下消化道组（30.4%）更常见。另一方面，发育迟缓患者并发症发生率更高且住院时间延长（分别为P = 0.003和P = 0.037），而体重不足的下消化道患者住院时间延长（P = 0.02）。术前贫血患者比无术前贫血患者需要输血的比例更高（P = 0.003）。
营养评估是小儿外科患者管理的关键组成部分。体重不足和消瘦状况在肝胆和上消化道患者中更为常见。发育迟缓患者术后并发症和住院时间长更为常见。
