Malnutrition on admission to the paediatric cardiac intensive care unit increases the risk of mortality and adverse outcomes following paediatric congenital heart surgery: A prospective cohort study

Abstract

BackgroundMalnutrition is a common problem in children with congenital heart disease, and it increases the risk of adverse outcomes in the postoperative period. ObjectivesWe aimed to assess the association between malnutrition and cardiac surgery outcomes in paediatric patients aged 0–36 months. MethodsThis prospective cohort study was performed in a hospital specialising in paediatric cardiothoracic surgery. Children aged 0–36 months admitted to the paediatric cardiac intensive care unit after elective cardiac surgery between January 2018 and July 2018 were included in the study. We evaluated the patients' demographics and clinical variables, nutritional status, adverse outcomes, and 30-day mortality rates. ResultsA total of 124 cases met the inclusion criteria. Results showed that the Risk Adjustment for Congenital Heart Surgery score ≥5, underweight status (weight-for-age Z score ≤−2), and stunting (length-for-age Z score ≤−2) were all indicators for increased mortality following congenital heart surgery. Underweight children also spent a prolonged stay in the intensive care unit. Stunting (length-for-age Z score ≤−2) was the most strongly associated variable with mortality. ConclusionThe results confirm the impact of malnutrition on mortality, postoperative infection, and length of hospitalisation in children undergoing surgery for congenital heart disease.