Nutritional Status Of Pediatric Patients Research Articles

Effects of early enteral nutrition on gastrointestinal function recovery and nutritional status after gastrointestinal surgery in children

Background: Young children are at a developmental stage, and any change in their body growth/development and nutritional status during this period has a direct impact on the prognosis of a specific disease. Clinically, most of the pediatric patients receiving an abdominal surgery are children with congenital malformations of the digestive system. They often have compromised nutritional status after the surgery due to factors including surgical trauma and stress reaction. Therefore, reasonable nutrition support has become a required intervention. In this prospective study, we investigated the influence of early enteral nutrition (EEN) on gastrointestinal (GI) function recovery and nutritional status after GI surgery in children. Methods: A total of 60 children with GI diseases undergoing surgical treatment in our center from January 2017 to December 2018 were enrolled in this study. They were randomly divided into the control group and the EEN group according to the order of admission. No EEN was applied in the control group; in contrast, the EEN group received EEN via percutaneous endoscopic jejunostomy (PEJ) tube and postoperative jejunostomy tube. The recovery of GI function, changes in biochemical indicators within 7 days after surgery, postoperative nutritional status, and complications were compared between these two groups. Results: After the surgery, the time to eating solid food and the time to first flatus/defecation were significantly shorter in the EEN group than in the control group (all P Conclusions: Proper EEN after a GI surgery can increase the survival rate, accelerate the recovery of GI function, and improve the nutritional status in pediatric patients. This intervention can be further applied in clinical settings.

Estado Nutricional de Pacientes Pediátricos Recém-Diagnosticados com Leucemia Linfoblástica Aguda em um Instituto de Referência em Oncologia do Rio de Janeiro

Introdução: A leucemia linfoblástica aguda (LLA ) constitui a neoplasia mais comum em pediatria e a avaliação nutricional é um instrumento essencial para conhecer as condições de saúde dos pacientes. O presente estudo teve como objetivo avaliar e descrever o estado nutricional de pacientes pediátricos recém-diagnosticados com LLA e verificar a relação do índice de massa corporal para idade (IMC/I) com as demais medidas antropométricas. Método: Estudo observacional, transversal, realizado com pacientes de 1 a 18 anos, recém-diagnosticados com LLA , no período de janeiro/2004 a dezembro/2009. Os dados coletados foram idade, peso corporal, estatura, prega cutânea tricipital (PCT), circunferência do braço (CB) e circunferência muscular do braço (CMB). O IMC foi calculado e a classificação IMC/I utilizada na análise. O teste Qui-quadrado de Pearson e Exato de Fisher foram utilizados para analisar a associação entre os parâmetros antropométricos. Resultados: Foram incluídos no estudo 54 pacientes. A classificação do “estado nutricional adequado” foi a mais frequente em todos os parâmetros antropométricos. Em adição, observou-se que a associação do estado nutricional pela CMB com o IMC/I (p=0,001) demonstra que este último pode ser adequado para classificação dos pacientes pediátricos com LLA ao diagnóstico. E a concordância da CB com a CMB (p=0,01) de 43% (p=0,001) também ratifica a utilização da CB frente à CMB, por ser uma medida mais simples. Conclusão: Na população estudada, o estado nutricional encontrava-se preservado. Assim como a associação da CMB com o IMC/I, a CB demonstrou ser um parâmetro sensível para classificar eutrofia.

Patient-Generated Subjective Global Assessment of nutritional status in pediatric patients with recent cancer diagnosis.

The subjective global assessment (SGA) is a simple, sensitive tool used to identify nutritional risk. It is widely used in the adult population, but there is little evidence on its effectiveness in children with cancer. This cross-sectional study was undertaken to demonstrate significant correlation between a simplified version of the Patient-Generated SGA (PG-SGA) and anthropometric assessment to identify nutritional status in children recently diagnosed with cancer. The nutritional status of 70 pediatric cancer patients was assessed with the PG-SGA and anthropometric measurements. The relation between the assessments was tested with ANOVA, independent samples t-test, Kappa statistic, and non-parametric Spearman and Kendall correlation coefficient. The PG-SGA divided the patients into four groups: well nourished, mildly, moderately and severely malnourished. The prevalence of malnutrition according to the PG-SGA was 21.4%. The correlations (r ≥ 0.300, p < 0.001) and the concordance (k ≥ 0.327, p < 0.001) between the PG-SGA and anthropometric indicators were moderate and significant. The results indicate that the PG-SGA is a valid tool for assessing nutritional status in hospitalized children recently diagnosed with cancer. It is important to emphasize that the subjective assessment does not detect growth retardation, overweight or obesity.

IL‐6, TNF‐α, IL‐10, and nutritional status in pediatric patients with biliary atresia

ObjectivesThe objective of the present study is to evaluate whether IL‐6, TNF‐α, IL‐10 are associated with nutritional status in patients with cirrhosis secondary to biliary atresia and compare to healthy controls. MethodsThe parameters used for nutritional assessment were the standard deviation scores of height‐for‐age and of triceps skinfold thickness‐for‐age. The severity of cirrhosis was evaluated using the Child‐Pugh score and PELD/MELD. Serum cytokines were measured using Cytometric Bead Array flow cytometry. ResultsIL‐6, TNF‐α, and IL‐10 were significantly higher in the cirrhosis group when compared with the control group 2.4 vs. 0.24 (p<0.001), 0.21 vs 0.14 (p=0.007), and 0.65 vs. 0.36 (p=0.004), respectively. IL‐6 and IL‐10 were positively correlated with disease severity (0.450 [p=0.001] and 0.410; [p=0.002], respectively). TNF‐α did not show a significant correlation with disease severity (0.100; p=0.478). Regarding nutritional evaluation, IL‐6 was negatively correlated with the standard deviation score of height‐for‐age (−0.493; p<0.001) and of triceps skinfold thickness‐for‐age (−0.503; p<0.001), respectively. IL‐10 exhibited a negative correlation with the standard deviation score of height‐for‐age (−0.476; p<0.001) and the standard deviation score of triceps skinfold thickness‐for‐age (−0.388; p=0.004). TNF‐α did not show any significance in both anthropometric parameters −0.083 (p=0.555) and −0.161 (p=0.253). ConclusionThe authors suggest that, in patients with cirrhosis secondary to biliary atresia, IL‐6 could be used as a possible supporting biomarker of deficient nutritional status and elevated IL‐10 levels could be used as a possible early‐stage supporting biomarker of deteriorating nutritional status.

ASSESSMENT OF NUTRITIONAL STATUS OF CHILDREN AND ADOLESCENTS WITH SPASTIC QUADRIPLEGIC CEREBRAL PALSY.

Due to several factors, such as gastrointestinal's diseases and difficulty in feeding, children with Spastic Quadriplegic Cerebral Palsy tend to present nutritional deficits. To assess the nutritional status of pediatric patients with Spastic Quadriplegic Cerebral Palsy according to reference curves for this population and with the measures of folds and circumferences, obtained by the upper arm circumference and triceps skin fold. The data were obtained from: knee-height, estimated height, weight, upper arm circumference, and triceps skin fold. Values of folds and circumferences were compared with Frisancho, and specific curves for these patients were used as reference. The relationship between the values in the growth curve for healthy children, Z-Score, and comparison with the reference curve were verified by Fisher's exact test. We adopted the significance level of 5%. We evaluated 54 patients. The mean age was 10.2 years, and 34 were male, 25 fed by gastrostomy and 29, orally. The frequency of low weight by the reference curve was 22.22%. More than half of the patients presented the parameters indicating lean mass below the 5th percentile. The height of all patients was classified as adequate for the age by the reference curve. Low weight was found in 22% of patients, and there is a greater tendency to present reduced muscle mass and increased fat mass, showing the need for evaluation and appropriate interventions for patients with Spastic Quadriplegic Cerebral Palsy.

Cross-cultural adaptation and content validation into Portuguese of the Subjective Global Nutritional Assessment for pediatric patients hospitalized with cancer

ABSTRACT Objective Cross-cultural adaptation and content validation of the Brazilian Portuguese version of the Subjective Global Nutritional Assessment questionnaire (originally in English) for use in hospitalized children and adolescents being treated in a reference institute of oncology. Methods The cross-cultural adaptation process consisted of the following stages: conceptual, item, semantic, and operational equivalence. The conceptual equivalence and item was carried out through discussion with members of an expert committee. Semantic equivalence was evaluated through initial translation, synthesis of translations, back translation, discussions with experts, and pretest with 32 patients. During operational equivalence, the experts discussed about the format of questions and instructions, setting, target populations, and mode of administration to later propose a final version. Content validation was performed by the expert committee. Results Minor modifications were made in the instrument to facilitate its use in the Brazilian socio-cultural context. Pretest results showed that the instrument is easily understood by health care professionals and the target population. Conclusion The cross-cultural adaptation and validation of the Subjective Global Nutritional Assessment allowed obtaining a Brazilian version equivalent to the original. The adapted instrument will be an important tool for the subjective assessment of the nutritional status of pediatric patients hospitalized with cancer.

IL-6, TNF-α, IL-10, and nutritional status in pediatric patients with biliary atresia

ObjectivesThe objective of the present study is to evaluate whether IL-6, TNF-α, IL-10 are associated with nutritional status in patients with cirrhosis secondary to biliary atresia and compare to healthy controls. MethodsThe parameters used for nutritional assessment were the standard deviation scores of height-for-age and of triceps skinfold thickness-for-age. The severity of cirrhosis was evaluated using the Child–Pugh score and PELD/MELD. Serum cytokines were measured using Cytometric Bead Array flow cytometry. ResultsIL-6, TNF-α, and IL-10 were significantly higher in the cirrhosis group when compared with the control group (2.4 vs. 0.24 (p<0.001), 0.21 vs. 0.14 (p=0.007), and 0.65 vs. 0.36 (p=0.004), respectively. IL-6 and IL-10 were positively correlated with disease severity (0.450 [p=0.001] and 0.410; [p=0.002], respectively). TNF-α did not show a significant correlation with disease severity (0.100; p=0.478). Regarding nutritional evaluation, IL-6 was negatively correlated with the standard deviation score of height-for-age (−0.493; p<0.001) and of triceps skinfold thickness-for-age (−0.503; p<0.001), respectively. IL-10 exhibited a negative correlation with the standard deviation score of height-for-age (−0.476; p<0.001) and the standard deviation score of triceps skinfold thickness-for-age (−0.388; p=0.004). TNF-α did not show any significance in both anthropometric parameters (−0.083 (p=0.555) and −0.161 (p=0.253). ConclusionThe authors suggest that, in patients with cirrhosis secondary to biliary atresia, IL-6 could be used as a possible supporting biomarker of deficient nutritional status and elevated IL-10 levels could be used as a possible early-stage supporting biomarker of deteriorating nutritional status.

Assessment of Body Composition in a Group of Pediatric Patients With Cancer: A Single Romanian Center Experience

Cancer patients are particularly susceptible to nutritional depletion. From March 2014 to December 2015, we assessed 146 patients consecutively hospitalized in a tertiary emergency pediatric hospital. The patients were divided into 2 groups: group I, patients with cancer (43 patients), and group II, the control group consisting of 103 age-matched and sex-matched healthy patients. The anthropometric parameters (weight-W, height-H, body mass index [BMI], middle upper arm circumference [MUAC], tricipital skinfold thickness [TST]) and biochemical parameters (proteins, albumin) were comparatively evaluated. Fat mass (FM, kg and %), fat-free mass (FFM, kg), muscle mass (MM, kg), and total body water (TBW, %) were measured in both groups using Tanita BC 420 S MA Analyzer. Anthropometric and biochemical parameters in group I were significantly different from those in group II for weight, height, BMI, MUAC, TST, protein, and albumin (P<0.05). In the study group, FM was much lower compared with controls 16.9% (3.4% to 33.3%) versus 20.3% (6.6% to 38.4%); (P=0.001), and TBW was much higher 60.8% (48.8% to 70.6%) versus 58.5% (45.2% to 68.6%) (P=0.004). FFM and MM were not statistically different in the 2 groups. The results highlight the complex changes of nutritional status in pediatric patients with cancer.

Alteraciones del crecimiento y en el estado nutricional de pacientes pediátricos infectados con VIH

Antecedentes: la infancia es el periodo más importante de crecimiento físico y de desarrollo cognitivo de las personas. Diversos estudios mues- tran que el crecimiento y estado nutricional de los pacientes pediátricos infectados con VIH generalmente se encuentran alterados. Objetivo: evaluar la prevalencia en las alteraciones en el crecimiento y en el estado nutricional de pacientes pediátricos, infectados con VIH, atendidos en la Clínica de VIH del Instituto Nacional de Pediatría. Materiales y métodos: estudio observacional, descriptivo, transversal, de una muestra de 49 pacientes: 22 niñas y 27 niños de entre 3 meses y 18 años de edad. Se les realizó una evaluación completa del estado nutricional en la que se consideraron indicadores antropométricos, bioquímicos, clínicos y dietéticos. Resultados: la alteración del estado nutricional que se encontró con más frecuencia fue la desnutrición crónica compensada. Se observó una mayor prevalencia de desnutrición aguda en lactantes y preescolares. En los pacientes hospitalizados se observó una mayor frecuencia de desnutrición aguda. En la evaluación bioquímica se buscaron dislipi- demias y anemia. El 46.9% de la muestra presentó alguna alteración en las concentraciones plasmáticas de triglicéridos, colesterol total, o ambos. En la evaluación clínica el síntoma que se presentó con mayor frecuencia fue la diarrea en 100% de los pacientes hospitalizados. La evaluación dietética mostró que ninguno de los pacientes cumplía con todos los criterios de una dieta correcta en su alimentación. Conclusiones: con los resultados de este estudio se evidencia la impor- tancia de la intervención nutricional en los pacientes de la Clínica de VIH del Instituto Nacional de Pediatría, por lo que se debe considerar incluir a un nutriólogo como parte del equipo multidisciplinario.

Energy Expenditure and Nutritional Status in Pediatric Patients before and after Lung Transplantation

Resting energy expenditure and nutritional status in pediatric patients was determined before and then 1 and 2 years after lung transplantation. Mean resting energy expenditure was increased (132%) before transplantation and declined (112%) after transplantation. Body mass index and weight z-scores improved posttransplantation, but nutritional measurements remained below normal population values.

Relationship of serum insulin-like growth factor I (IGF-I) with nutritional status in pediatric patients with malignant diseases—a single Romanian center experience

The aim of this study was to analyze insulin-like growth factor I (IGF-I) serum level in pediatric patients with cancer compared with pediatric patients with nononcological diseases and to assess the relationship between IGF-I and nutritional status of oncological patients. From January 2009 to July 2012, we assessed 151 consecutively hospitalized patients in a tertiary emergency pediatric hospital. The patients were divided into two groups: group I, consisting of patients with malignant diseases (64 patients), and group II, the control group, consisting of 87 age- and gender-matched patients with different pediatric diseases. The anthropometric parameters (weight, height, body mass index, middle upper arm circumference (MUAC), and tricipital skinfold thickness (TST) and biochemical parameters (proteins, albumin, and total IGF-I) were comparatively evaluated at the diagnosis and after intensive chemotherapy in the malignant group. Anthropometric and biochemical parameters in group I were significantly different from those in group II for height, MUAC, TST, total proteins, and albumin (p < 0.05). Twenty-five out of 64 patients with malignant diseases and 5 out of 87 patients in the control group had malnutrition. IGF-I in patients with cancer was much lower than in the control group (median 48.3 ng/ml, range 25.00-662.00 ng/ml vs 129.00 ng/ml, range 25.00-745.00 ng/ml) (p = 0.014). We found a positive correlation between IGF-I, MUAC, and TST at the diagnosis of the malignant disease. Also, we identified positive correlations between IGF-I, protein, and albumin. Serum IGF-I levels in cancer patients were significantly lower at diagnosis than after chemotherapy (48.3 ng/ml, range 25.00-662.00 ng/ml vs 110.0 ng/ml, range 25.00-573.00 ng/ml; p = 0.04). IGF-I seems to be an accurate biochemical parameter used in malnutrition assessment of children with cancer. IGF-I correlated with the anthropometric parameters of the arm, serum protein, and albumin. These parameters most accurately characterize the nutritional status.

Nutritional status among pediatric cancer patients: A comparison between hematological malignancies and solid tumors

This study aimed to compare the nutritional status of pediatric patients with hematological malignancies and solid tumors. A total of 74 pediatric cancer patients were assessed for anthropometric status, biochemical profiles, and dietary intake. The prevalence of undernutrition was higher among patients with solid tumors as reflected in their lower dietary intakes of energy and nutrients compared with patients with hematological malignancies. Adequate dietary intake is important for pediatric cancer patients, but nurses need to pay more attention to the diets of patients with solid tumors as compared with those with hematological malignancies.

Nutritional risk and anthropometric evaluation in pediatric liver transplantation

OBJECTIVE:To analyze the nutritional status of pediatric patients after orthotopic liver transplantation and the relationship with short-term clinical outcome.METHOD:Anthropometric evaluations of 60 children and adolescents after orthotopic liver transplantation, during the first 24 hours in a tertiary pediatric intensive care unit. Nutritional status was determined from the Z score for the following indices: weight/age, height/age or length/age, weight/height or weight/length, body mass index/age, arm circumference/age and triceps skinfold/age. The severity of liver disease was evaluated using one of the two models which was adequated to the patients' age: 1. Pediatric End-stage Liver Disease, 2. Model for End-Stage Liver Disease.RESULTS:We found 50.0% undernutrition by height/age; 27.3% by weight/age; 11.1% by weight/height or weight/length; 10.0% by body mass index/age; 61.6% by arm circumference/age and 51.0% by triceps skinfold/age. There was no correlation between nutritional status and Pediatric End-stage Liver Disease or mortality. We found a negative correlation between arm circumference/age and length of hospitalization.CONCLUSION:Children with chronic liver diseases experience a significant degree of undernutrition, which makes nutritional support an important aspect of therapy. Despite the difficulties in assessment, anthropometric evaluation of the upper limbs is useful to evaluate nutritional status of children before or after liver transplantation.

Clinical and Nutritional Outcomes in Children With Idiopathic Superior Mesenteric Artery Syndrome

There are no available data for outcomes in children's idiopathic superior mesenteric artery syndrome (SMAS) strictly treated conservatively. The aim of the study was to evaluate clinical and nutritional outcome in children with idiopathic SMAS. A 1-year prospective observation study of effects of treatment and outcome was performed in 27 children (8 boys, 19 girls) with idiopathic SMAS who underwent an upper gastrointestinal (UGI) series, ultrasound measurement of the aortomesenteric angle, treatment, clinical assessment, growth evaluation, and regular clinical visits for more than 12 months. Mean age of the patients was 11.77 +/- 2.15 years. The major clinical complaints were postprandial pain or fullness (88.9%), vomiting (55.6%), and early satiety (51.9%). Eight patients (29.6%) had weight loss. The UGI series revealed typical features of SMAS. The aortomesenteric angle on ultrasound was 10 degrees to 19 degrees. The height of most patients (92.6%) was above the 10th percentile, whereas 15 (55.6%) patients weighed below the 10th percentile. Six patients underwent surgical intervention (3 for obstruction and 3 for persistent anorexia with weight loss), and their clinical symptoms and weight status improved steadily during the follow-up months. Among the 21 patients not subject to surgical intervention, 11 (52.4%) experienced a reduction of symptoms >50% after 3 months of treatment, and weight-for-age percentile increased significantly after 6 months of treatment. Overall, a significant increase in the weight-for-age status was seen in the patients with surgical treatment or with medication only after 6 and 12 months of treatment. An aortomesenteric angle <20 degrees is a constant phenomenon in children with idiopathic SMAS. A duodenojejunostomy can effectively relieve the obstructive symptoms, such as anorexia, and improve nutritional status, whereas long-term medical treatment may aid in relieving the clinical symptoms, promoting appetite, and improving nutritional status in pediatric patients with idiopathic SMAS.

Subjective vs objective nutritional assessment study in children: a cross-sectional study in the northwest of Iran

Different methods have been used to assess nutritional status in hospitalized pediatric patients, and there is no agreement on the finest index which reflects nutritional status. The aim of this study was to compare the subjective global assessment (SGA) and objective assessment of nutritional status in hospitalized pediatric patients. One hundred forty children with mean age of 6.43 +/- 0.23 years hospitalized consecutively in Tabriz Pediatric Hospital from June to August in 2008 underwent a subjective assessment using the SGA questionnaire and objective assessment (anthropometric and biochemical measurements). An agreement between 2 assessment methods were analyzed by the kappa statistic. According to the result of SGA method, the overall prevalence of malnutrition was higher than the objective assessment method. The agreement between the 2 methods were merely fair to moderate (kappa = 0.336, P = .000). The linear relationship between 2 methods was also fair to moderate (r = 0.374, P < .05). Our findings indicated that the differences between two evaluated methods in assessing nutritional status of pediatric patients, and it can also detect the changing trend of nutritional status, which may be missed by one-time anthropometry and biochemical methods.

Assessment of body composition in pediatric patients with cystic fibrosis

Cystic fibrosis (CF) leads to pathological changes in organs that express the cystic fibrosis transmembrane conductance regulator (CFTR), including secretory cells of the digestive tract and the pancreas. Maintaining nutritional sufficiency is challenging for CF patients and therefore accurate monitoring is important for their clinical management. The objectives of this study were to evaluate the effectiveness of skinfold measurements as an accurate method for determining body composition (fat mass (FM) and lean body mass (LBM)) of this population, using dual-energy X-ray absorptiometry (DEXA) as a gold standard comparison and to determine the most accurate equation for this calculation in children with CF. Fifty-five pediatric patients with CF participated in the study. FM and LBM calculated via four methods: Slaughter, Durnin, Durenberg (2-site and 4-site). The relationship between the methods and DEXA results were estimated by intraclass-correlation coefficient (ICC) and Bland and Altman analyses. The Slaughter method was the most accurate (ICC of 0.92 for FM and 0.99 for LBM) and displayed the least bias over the range of FM and LBM in CF patients. In addition, the results of Bland Altman analyses comparing each skinfold method to DEXA, revealed that the results were evenly distributed along the range of values for the Slaughter calculation, whereas the other three methods under and over estimated % fat results at the upper and lower ends of the range respectively. We therefore conclude that the Slaughter method may be used for body composition assessment of pediatric CF patients. This provides clinical teams with a simple, accurate and non-invasive method that can be used to monitor nutritional status in pediatric patients with CF.

Suitable Dialytic Indicators for Pediatric Peritoneal Dialysis Patients: The Alternative to Creatinine Clearance

Owing to the discord between body weight and body surface area (BSA), creatinine clearance (CCr) is predisposed to be small in pediatric patients on peritoneal dialysis (PD). Alternatively, Kt/V creatinine (Kt/V creat), which is normalized to total body water (TBW) rather than BSA, could be a better dialytic indicator. In this study, the efficiency of dialysis and the nutritional status of pediatric patients on chronic PD were examined, and the utility of dialytic indicators was evaluated. 49 patients under 20 years old, in stable condition, and on PD were analyzed. Weekly total Kt/V of urea (Kt/V urea), CCr, Kt/V creat, and normalized protein equivalent of nitrogen appearance (nPNA) were measured for all patients and for patients under 6 years old. The target value was 2.0/week for Kt/V urea and 60 L/ week/1.73 m2 for CCr, as recommended by the Kidney Disease Outcomes Quality Initiative guidelines. The target value for Kt/V creat was set as 1.52/week, using a male model with a height of 170 cm and a body weight of 65 kg. The mean values of delivered Kt/V urea, CCr, Kt/V creat, and nPNA (and proportion of patients that achieved each target value) for all patients were 2.25 +/- 0.57/ week (67.4%), 53.8 +/- 19.3 L/week1/.73 m2 (26.5%), 1.83 +/- 0.73/ week (65.3%), and 1.11 +/- 0.42 g/day, respectively. The values for patients under 6 years old were 2.38 +/- 0.26/week (90.0%), 45.9 +/- 12.8 L/week/1.73 m2 (10.0%), 1.94 +/- 0.51/week (90.0%), and 1.52 +/- 0.67 g/day, respectively. Stepwise multiple regression analyses revealed that the relationship between CCr and Kt/V urea was affected by the patient's age. Our pediatric patients achieved the recommended target value of Kt/V urea. At the same time, the nPNA results reflected the patient's status well. However, CCr appeared to be inappropriate as an indicator for patients under 6 years old. Kt/V creat is suggested to be a better dialytic indicator for these patients.

Clinical Significance of Preoperative Nutritional Status in Pediatric Surgical Patients

This prospective study was undertaken to correlate the preoperative nutritional status in pediatric surgical patients with postoperative morbidity. The prevalence of protein-calorie malnutrition in our patients is also evaluated. Sixty-two consecutive pediatric surgical patients were admitted elective to King Khalid University Hospital for different reasons. Seventy-four major and intermediate surgical procedures were carried out. The patients were assessed nutritionally on the day of admission by using anthropometric and biochemical methods. Patients were monitored for complications during their hospital course. Eighty percent of patients have one or more abnormal values suggestive of protein-calorie malnutrition. Six patients had 8.1% complication rate. Five of them showed moderate to severe malnutrition. The correlation between malnutrition and postoperative morbidity was evident but was not of clinical or statistical significance. And the predictive value of nutritional variables in predicting postoperative complications were difficult to assess in this study but they generally were of little help.