Preoperative nutritional status assessment and clinical outcomes in pediatric patients undergoing gastrointestinal surgery: a prospective study

Abstract

Background: The objective was to assess the association between preoperative nutritional status and postoperative outcomes in children undergoing gastrointestinal surgery. Methods: This prospective study recruited pediatric patients diagnosed with gastrointestinal surgical pathology from the pediatric surgical department in a tertiary care hospital during the period from April 2023 to October 2023. Sixty surgical cases were included in our study from both genders. An organized questionnaire was created. This questionnaire involved 3 major parts: demographic and nutritional status parameters at admission and discharge. Comparison of nutritional status pre- and postoperatively were done. Results: A total of 60 pediatric patients were enrolled. According to both STRONGKIDS score and the subjective global nutritional assessment, 58.3% of upper gastrointestinal (GI) group were at risk of malnutrition. Wasting was more common in the upper GI group 75%; versus 36.8% in the lower GI group. Underweight was more common in the hepatobiliary and upper GI groups (nearly 41.7% for each group) than in the lower GI group (26.3%). Furthermore, stunted patients had a higher incidence of complications and a prolonged hospital stay (>7 days) (p=0.001 and p=0.028, respectively), while underweight lower GI patients showed a prolonged hospital stay (p=0.017). Conclusions: Nutritional assessment is an essential part of surgical management of pediatric patients. Both underweight and wasting statuses were more common among hepatobiliary and upper GI groups. A long hospital stay and postoperative complications were more common among stunted patients.