Perioperative Nutritional Status and Organ Dysfunction Following Surgery for Congenital Heart Disease

Preoperative Nutrition Status in Children with Congenital Heart Disease and Its Impact on Postoperative Outcomes – A Systematic Review and Meta-Analysis

“…Previous studies have postulated that decreased immunity caused by malnutrition impedes effective physiological stress response produced during surgery 22 . One study determined the impact of malnutrition on organ dysfunction following surgery, concluding that malnutrition is signi cantly associated with higher rates of organ dysfunction, which ultimately increases the ICU stay 45 . Additionally, our review revealed that malnourished children were associated with a higher mortality risk score (RACHS-1 or STAT score), which aligns with ndings from a large-scale cohort conducted in China where an RACHS-1 score of > 3 was strongly associated with malnutrition 58 .…”

“…A total of 4090 studies were identi ed via our search strategy and manual bibliography review, of which 16 studies meeting the eligibility criteria were included in the nal review (PRISMA diagram can be seen in Fig. 1) [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] . This data comprised a total of 2003 malnourished children and 4681 well-nourished children with CHD.…”

“…Six studies used weight-for-age z-score (WAZ) charts/software provided by the World Health Organization (WHO) 49,50 and de ned malnutrition as less than − 2 standard deviations (SD) [35][36][37][38][39]46 . Overall, 7 studies were conducted in high-income countries (HICs) 33,36,39,40,42,45,47 , 6 in upper-middle-income countries (UMICs) 35,37,38,43,46,48 , and 3 in lower-middle-income countries (LMICs) 34,41,44 based on the World Bank classi cation 51 . For subgroup analysis, UMIC and LMIC studies were combined into one category, called middle-income countries (MIC).…”

“…A Z-score of less than − 2 in any category was de ned as malnutrition. While extracting comparative data between malnourished and well-nourished patients, ventilation time was reported by 12 studies [33][34][35][36][37][38][39][40]43,[45][46][47] , LOS in ICU was reported by 11 studies [33][34][35][36][37][38][39][40][45][46][47] , LOS in hospital was reported by 8 studies 33,[35][36][37]42,43,45,47 , mortality was reported by 8 studies 33,36,41,42,[44][45][46]48 , postoperative infections rates by 3 studies 34,37,41 , and RACHS-1/STAT scores by 5 studies 33,34,36,38,45 . Post-operative infections included ventilator-associated pneumonia and bloodstream sepsis.…”