Assessment of the nutritional status of children admitted to thoracic surgical department

Abstract

Background. Numerous studies aimed at assessing the nutritional status and organizing nutritional support for surgical patients cover the adult patients, only a handful assess underaged patients with surgical pathology in the pre- and postoperative period and their needs for assessment of the nutritional status and approaches to their dietary correction.
 Aim. To assess the possible risks of developing malnutrition in children with various pathologies of the chest organs during the preoperative period, and to conduct a comprehensive assessment of their nutritional status.
 Materials and methods. The single-center non-comparative cross-sectional study included 50 children between 5 months and 17 years 7 months, hospitalized in the thoracic department of the National Medical Research Center for Children's Health of the Ministry of Health of the Russian Federation. All patients underwent an assessment of clinical and anamnestic data, somatometric and clinical laboratory parameters, and Z-scores analyzed: body weight/age, height/age, BMI/age, shoulder circumference, skin-fat folds above the triceps and under the scapula, as well as a number of biochemical parameters (concentrations of total protein, albumin, prealbumin, transferrin and C-reactive protein).
 Results. When assessing the nutritional status of children upon admission to the thoracic department, acute malnutrition was detected in 21 (42%) patients (of which 10% had mild, 14% moderate, and 18% severe malnutrition), chronic malnutrition was found in 18% of children. For the first time in Russia, using a validated Russian-language version of the STRONGkids screening questionnaire, nutritional risks of malnutrition have been assessed. The vast majority of patients were at moderate (28%) or high (70%) risk of developing malnutrition or its aggravation. Z-scores of skin-fat folds above the triceps and under the scapula, as well as the circumference of the shoulder were within the reference values. 16 (36%) patients had a decrease in the concentration of total protein, 10 (22%) had a drop of prealbumin accompanied by an increase (40%) of the C-reactive protein level. The levels of other proteins were within the reference values.
 Conclusion. The identified risks of malnutrition and its moderate/severe manifestations in children with surgical pathology are able to contribute to the development of infectious and non-infectious postoperative complications, increase the length of stay in the clinic, and require nutritional support from the first day of hospitalization in a surgical hospital.