Nutritional status and outcome of surgery : A prospective observational cohort study of children at a tertiary surgical hospital in Harare, Zimbabwe

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Nutritional status and outcome of surgery : A prospective observational cohort study of children at a tertiary surgical hospital in Harare, Zimbabwe

Bergkvist, Emil (author): Lund University

Zimunhu, Taurai (author): University of Zimbabwe

Mbanje, Chenesa (author): University of Zimbabwe

Hagander, Lars (author): Lund University,Lunds universitet,Barnkirurgi,Forskargrupper vid Lunds universitet,Pediatric surgery,Lund University Research Groups

Muguti, G. I. (author): University of Zimbabwe

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Elsevier BV, 2021
2021
English.
In: Journal of Pediatric Surgery. - : Elsevier BV. - 0022-3468. ; 56:2, s. 368-373

Related links:: http://dx.doi.org/10...; show more...; https://lup.lub.lu.s...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Background: Undernutrition contributes to nearly 50% of all child deaths in the world, yet there is conflicting evidence regarding the association between nutritional status and postoperative complications. The aim was to describe the preoperative nutritional status among pediatric surgery patients in Zimbabwe, and to assess if nutritional status was a risk factor for adverse postoperative outcome of mortality, surgical site infection, reoperation, readmission, and longer length of stay. Methods: This prospective observational cohort study included 136 children undergoing surgery at a tertiary pediatric hospital in Zimbabwe. Nutritional status was standardized using Z-scores for BMI, length, weight, and middle upper arm circumference. Primary outcomes after 30 days included mortality, surgical site infection, reoperation, and readmission. Secondary outcome was length of stay. Univariate and multivariable analyses with logistic regression were performed. Results: Of the 136 patients, 31% were undernourished. Postoperative adverse outcome occurred in 20%; the mortality rate was 6%, the surgical site infection rate was 17%, the reoperation rate was 3.5%, and readmission rate was 2.5%. Nutritional status, higher ASA classification, major surgical procedures, and lower preoperative hemoglobin levels were associated with adverse outcome. Univariate logistic regression identified a seven-fold increased risk of postoperative complications among undernourished children (OR 7.3 [2.3–22.8], p = 0.001), and there was a four- to six-fold increased adjusted risk after adjustment for ASA, major surgery, and preoperative hemoglobin. Conclusion: A third of all pediatric surgery patients were undernourished, and undernourished children had a considerably higher risk of adverse outcome. With a positive correlation identified between undernourishment and increased postoperative complications, future aims would include assessing if preoperative nutritional treatment could be especially beneficial for undernourished children. Levels of Evidence: Level II treatment study.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Näringslära (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nutrition and Dietetics (hsv//eng)

Keyword

Nutritional status
Pediatric surgery
Perioperative mortality
Postoperative complications
Zimbabwe

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By the author/editor: Bergkvist, Emil; Zimunhu, Taurai; Mbanje, Chenesa; Hagander, Lars; Muguti, G. I.

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Pediatrics

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences; and Nutrition and Di ...

Articles in the publication: Journal of Pedia ...

By the university: Lund University

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