Clinical Significance of Preoperative Nutritional Status in Pediatric Surgical Patients

Albassam, A.A.

doi:10.5144/0256-4947.1994.511

Cited by 5 publications

(12 citation statements)

References 17 publications

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“…This incidence was >50% in four of the included studies, 12,13,23,26 and the lowest rate was found in the largest cohort study which reported an incidence of 14.5%. 21 A formula using height and/or weight parameters was most commonly used to assess nutritional status.…”

Section: Methods Of Nutritional Assessmentmentioning

confidence: 77%

“…23 Four studies were undertaken in cardiac surgical populations, 13,20,21,29 and four studies were undertaken in general surgical populations, mainly gastrointestinal/abdominal surgery. 16,17,26,27 Two studies were performed in spinal surgical populations, 25,29 and one study comprised of cardiac, neurosurgical and general surgical participants. 24 Stey et al reported on all children undergoing any type of surgery with data entered on to the American College of Surgeons National Surgical Quality Improvement Program Pediatric Report Form.…”

Section: Search Resultsmentioning

confidence: 99%

“…23,28 Prospective studies were more likely to use Waterlow's criteria based on expected values of height/weight for age. 13,16,17,26 Two studies used one of the above measures with the addition of triceps skin fold; the latter was used to estimate subcutaneous fat. 13,26 Two studies included some element of laboratory testing.…”

Section: Methods Of Nutritional Assessmentmentioning

confidence: 99%

“…23,24 Where participant numbers were low for the given study period, studies were downgraded to unclear risk of bias. 13,25,26 Unclear or non-validated infection definitions, 25 or unclear or less than accepted durations of follow-up made it difficult to assess exposure and/or case selection; these studies were downgraded accordingly. 13,16,17,20,21,24,26 Any study that adjusted for age and/or case complexity met the criteria for comparability.…”

Section: Quality Assessment Of Included Studiesmentioning

confidence: 99%

“…13,25,26 Unclear or non-validated infection definitions, 25 or unclear or less than accepted durations of follow-up made it difficult to assess exposure and/or case selection; these studies were downgraded accordingly. 13,16,17,20,21,24,26 Any study that adjusted for age and/or case complexity met the criteria for comparability. 20,21,23,24 Studies that did not provide details about adjustment, studies that reported 'no difference between groups', and studies that undertook…”

Section: Quality Assessment Of Included Studiesmentioning

confidence: 99%

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Is undernutrition prognostic of infection complications in children undergoing surgery? A systematic review

Hill

Paulus

Dey

et al. 2016

Journal of Hospital Infection

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Background: Healthcare-associated infections are costly and are increasingly viewed as an indicator of the quality of care. Although strategies to reduce infections have become widespread, few studies have formally investigated the role of undernutrition on the development of infection-related complications in children after surgery. Aim: To perform a systematic review of the literature to determine if undernutrition is prognostic of postoperative infection complications in children. Methods: Electronic bibliographic and research databases were searched from 1950 to 2014. Inclusion criteria were studies in children (age <18 years) evaluating pre-operative nutritional status and reporting postoperative infection complications. Quality assessment was performed independently by two reviewers, with disagreements resolved by a third reviewer. The quality of the evidence was judged to be low in the majority of studies. Findings: Ten cohort and two caseecontrol studies met the inclusion criteria. Five studies reported an outcome combining infection-related complications, with the remainder reporting individual infection complications. Six studies reported surgical site infection (SSI) alone or in combination with other infection complications. Direct comparison between studies was difficult due to clinical and diagnostic heterogeneity. Unadjusted analyses (for patient or clinical variables) were suggestive of a relationship between undernutrition and infection complications. In studies controlling for other variables, the analyses did not remain significant for SSI. Conclusion: There was low-quality evidence that undernutrition may be predictive of postoperative infection complications in children, with the exception of SSI. However, inconsistencies in nutritional and outcome assessments made it difficult to draw conclusions. Larger, high-quality studies are warranted to further investigate a potential prognostic relationship. ª

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Section: Methods Of Nutritional Assessmentmentioning

confidence: 77%

Section: Search Resultsmentioning

confidence: 99%

Section: Methods Of Nutritional Assessmentmentioning

confidence: 99%

Section: Quality Assessment Of Included Studiesmentioning

confidence: 99%

Section: Quality Assessment Of Included Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Is undernutrition prognostic of infection complications in children undergoing surgery? A systematic review

Hill

Paulus

Dey

et al. 2016

Journal of Hospital Infection

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Malnutrition in Children with Uncomplicated Versus Complicated Appendicitis

Chowdhury

Khastagir

Chowdhury

et al. 2022

J Chittagong Med Coll Teachers Ass

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Background : Acute appendicitis is one of the commonest surgical emergencies in children and malnutrition is prevalent in the country. This study was designed to compare if complicated appendicitis occurs more in malnourished children. Materials and methods: This cross-sectional study was conducted in Department of Paediatric Surgery, Chittagong Medical College Hospital from March 2017 to December 2019 with 155 children. Anthropometric measurements (Height, weight, Mid Upper Arm Circumference (MUAC) Triceps Skin Fold Thickness (TSFT) were recorded and biochemical assessment (Haemoglobin, albumin and total lymphocyte count) were done before surgery. Patients were grouped into two groups: Group A (Acute uncomplicated appendicitis; n=65) and Group B (Acute complicated appendicitis, n=90). Anthropometric and biochemical indices were compared between these two groups. Results: Age ranged from 2 -12 years (Mean 9.2 ±2.5 years) (Male: female- 1.35:1). Among the five anthropometric indices abnormal measurements in Group A vs Group B were respectively. Abnormal TSFT (73.8% vs 80%, p=0.4) wasting (38.5% vs 44.4%, p=0.4) low MUAC for age (13.8% vs 17.8%, p=0.8) low weight for age (30.8% vs 36.7%, p=0.5) and low height for age (21.5% vs 24.4%, p=0.7) low albumin (52.3% vs 83.3%, p<0,001); low haemoglobin (61.5% vs 60.0%, p=0.6)) and low total lymphocyte count (39.5% vs 44.8%, p=0.7). Conclusions: Malnutrition was widely prevalent in both groups. Although the proportion of malnutrition was more with acute complicated appendicitis, it was not statistically significant. The lower serum albumin level in these patients might be due to the consequence of the disease rather than prevailing malnutrition. JCMCTA 2022 ; 33 (1) : 66-70

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Correlation of Preoperative Nutritional Status and Postoperative Wound Infection in Children

Majumder

Karmaker²,

Nooruzzaman

et al. 2020

J. Surg. Sci.

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Background: Despite improvements in antimicrobial therapy, surgical technique and postoperative care, wound infection is still a major concern in pediatric surgical practice particularly in developing countries like Bangladesh. Objective: This study was conducted to ascertain the relationship between the preoperative nutritional status and postoperative wound infection in children as malnutrition is very prevalent among them. It was also decided to estimate the rate of wound infection in children and to identify the indicator of malnutrition that best predicts wound infection. Methods: This prospective study was carried out in the Department of Pediatric Surgery, BSMMU, Dhaka during the period of January 2009 to September 2010 and included consecutive 100 children undergoing routine surgery. Nutritional status was assessed by measuring BMI, serum albumin, haemoglobin and total lymphocyte count and thus children were categorized preoperatively. The children were assessed during the first 30 postoperative days for the evidence of wound infection that were confirmed by culture and sensitivity. Results: We found most of the wound infections among the malnourished children with low BMI and low serum albumin. Conclusion: Preoperative good nutritional status is associated with less postoperative wound infection and BMI and serum albumin are good indicators but total lymphocyte count and haemoglobin are not good indicators of protein calorie malnutrition and serum albumin is the best predictor of wound infection. Journal of Surgical Sciences (2019) Vol. 23(2): 48-53

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Clinical Significance of Preoperative Nutritional Status in Pediatric Surgical Patients

Cited by 5 publications

References 17 publications

Is undernutrition prognostic of infection complications in children undergoing surgery? A systematic review

Is undernutrition prognostic of infection complications in children undergoing surgery? A systematic review

Malnutrition in Children with Uncomplicated Versus Complicated Appendicitis

Correlation of Preoperative Nutritional Status and Postoperative Wound Infection in Children

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