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

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Abstract

Children with congenital heart disease (CHD) are at risk of malnutrition; however, there is limited information regarding the impact of nutritional status on organ dysfunction and outcomes after surgery for CHD. The study aim was to assess the association between malnutrition, organ dysfunction, and outcomes after surgery for CHD. Retrospective cohort study of patients aged 30 days to 18 years admitted to the cardiac intensive care unit (CICU) following cardiac surgery. Nutritional status (malnutrition defined as weight for age z-score < − 2) and validated organ dysfunction scores (pSOFA and PELOD-2) on CICU days 1 and 3 were collected. The cohort included 967 patients with a median age of 2.8 years (IQR 0.46, 7.12) and hospital survival of 98.86%. The prevalence of malnutrition was 18.5% (n = 179). By multivariable logistic regression analysis including age, malnutrition, cardiopulmonary bypass time, and duration of mechanical ventilation; High STAT category (OR 7.51 [1.03–54], p = 0.0462) and PSOFA score > 5 day 1 (OR 1.84 [1.25–2.72], p = 0.0021) were associated with mortality; in a similar model including the same variables; High STAT category (OR 9.12 [1.33–62], p = 0.0243) and PELOD-2 score > 5 day 1 (OR 1.75 [1.10–2.77], p = 0.0175) were associated with mortality. Malnutrition was associated with persistent or worsening organ dysfunction by pSOFA (p < 0.05) and PELOD-2 (p < 0.01) on day 3. Malnutrition was present in infants and children undergoing surgery for congenital heart disease. Organ dysfunction and high surgical risk were associated with mortality. Malnutrition was not associated with mortality but was associated with postoperative organ dysfunction.

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Authors and Affiliations

  1. Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA

    Jaime Silva-Gburek, Andrea Marroquín, Saul Flores, Jeramy Roddy, Lara S. Shekerdemian & Jorge A. Coss-Bu

  2. Division of Cardiology, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA

    Saul Flores & Lara S. Shekerdemian

  3. Division of Critical Care Medicine, Department of Pediatrics, University of Chicago, Chicago, IL, USA

    Nancy S. Ghanayem

Authors
  1. Jaime Silva-Gburek
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  2. Andrea Marroquín
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All seven authors have participated sufficiently and intellectually and fully contributed to the work to take public responsibility for the content of this article, including the conception, design, and conduction of the study. All the authors have approved the final version of the paper.

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Correspondence to Jorge A. Coss-Bu.

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Silva-Gburek, J., Marroquín, A., Flores, S. et al. Perioperative Nutritional Status and Organ Dysfunction Following Surgery for Congenital Heart Disease. Pediatr Cardiol 44, 1350–1357 (2023). https://doi.org/10.1007/s00246-023-03111-2

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  • DOI: https://doi.org/10.1007/s00246-023-03111-2

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