先天性心脏病患儿术前营养不良与术后早期结局的关联：黎巴嫩一家三级医疗中心的两年回顾性研究

The Association Between Preoperative Malnutrition and Early Postoperative Outcomes in Children with Congenital Heart Disease: A 2-Year Retrospective Study at a Lebanese Tertiary Medical Center.

作者信息

Assy Jana, Yaacoub Christelle, Khafaja Sarah, Arabi Mariam Toufic, El Rassi Issam, Bitar Fadi, Yazbeck Nadine

机构信息

Department of Pediatrics, University Hospital of Liege Belgium, 4000 Liège, Belgium.

Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut 1107, Lebanon.

出版信息

Children (Basel). 2025 May 29;12(6):705. doi: 10.3390/children12060705.

DOI:10.3390/children12060705

PMID:40564663

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12191067/

Abstract

OBJECTIVES

This study aimed to describe the prevalence of malnutrition and its impact on postoperative outcomes in infants and children with congenital heart diseases (CHDs) undergoing cardiac surgeries.

METHODS

We conducted a single-center, retrospective review of medical records of children aged 1 month to 5 years with CHDs who underwent cardiac surgery at the American University of Beirut Medical Center (AUBMC) between January 2015 and January 2017. Anthropometric data were collected and z-scores for weight-for-age (WAZ), height-for-age (HAZ), weight-for-height (WHZ), and BMI-for-age were calculated. Malnutrition was classified based on the World Health Organization (WHO) definitions and the American Society for Parenteral and Enteral Nutrition (ASPEN) criteria. The postoperative outcomes were analyzed using bivariate and multivariable models.

RESULTS

The prevalence of malnutrition was 33.8%, with children younger than 24 months having significantly higher odds of malnutrition. The most common CHDs were ventricular septal defect (VSD) and tetralogy of Fallot (TOF), with malnutrition being significantly more prevalent in the children with VSD. Malnutrition was significantly associated with a prolonged pediatric intensive care unit (PICU) stay, with underweight being the strongest predictor. Malnourished children also had a significantly longer mechanical ventilation time (median 9.0 vs. 5.0 h, = 0.017). Lower weight-for-age (WAZ) and BMI-for-age z-scores were associated with longer hospital stay, PICU stay, and mechanical ventilation durations.

CONCLUSIONS

Malnutrition is prevalent among children with CHDs and is independently associated with longer hospital and PICU stays, as well as extended mechanical ventilation. Early nutritional assessment and intervention may improve postoperative outcomes in this vulnerable population.

摘要

目的

本研究旨在描述先天性心脏病（CHD）患儿在接受心脏手术时营养不良的患病率及其对术后结局的影响。

方法

我们对2015年1月至2017年1月期间在美国贝鲁特美国大学医学中心（AUBMC）接受心脏手术的1个月至5岁CHD患儿的病历进行了单中心回顾性研究。收集人体测量数据，并计算年龄别体重（WAZ）、年龄别身高（HAZ）、身高别体重（WHZ）和年龄别BMI的z评分。根据世界卫生组织（WHO）的定义和美国肠外肠内营养学会（ASPEN）的标准对营养不良进行分类。使用双变量和多变量模型分析术后结局。

结果

营养不良的患病率为33.8%，24个月以下的儿童营养不良几率显著更高。最常见的CHD是室间隔缺损（VSD）和法洛四联症（TOF），VSD患儿中营养不良更为普遍。营养不良与儿科重症监护病房（PICU）住院时间延长显著相关，体重不足是最强的预测因素。营养不良的儿童机械通气时间也显著更长（中位数9.0 vs. 5.0小时，P = 0.017）。年龄别体重（WAZ）和年龄别BMI的z评分较低与住院时间、PICU住院时间和机械通气时间延长相关。