IMPACT OF NUTRITIONAL STATUS ON POSTOPERATIVE OUTCOMES IN PEDIATRIC SURGICAL PATIENTS
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Keywords
Nutritional status, postoperative outcomes, pediatric surgery, malnutrition, surgical complications, hospital stay, recovery time
Abstract
Background: Nutrition has a significant function in the prognosis of children who have surgeries. Malnourished children are at a higher risk of developing complications during the postoperative period, especially based on factors such as compromised wound healing rate and capacity or the immune system, and the rate of recovery from the physiological stress of surgery.
Objective: This study was aimed to determine the effect of nutritional status on post operative factor of children undergoing surgery.
Methods: This prospective observational study was conducted over 6 months from Aug, 2009 to Jan, 2010 in the Department of Paediatric Surgery, Khalifa Gulnawaz Teaching Hospital, Bannu Medical College, Bannu, Pakistan. A total of 130 pediatric patients, aged 1–14 years, were enrolled and divided into two groups based on nutritional status: The participants were divided into the malnourished group (n = 65) and the well-nourished group (n = 65). Information was obtained on anthropometric measurements, demographic characteristics, operative procedures, and findings, and the post-operative variables, including morbidity and mortality, length of hospital stay and recovery period. Data was analyzed using statistical packages SPSS version 26.0; p < 0.05 was used as cut off point for significant differences.
Results: Overall, the children with poor nutritional status produced significantly worse postoperative outcomes, for instance, having a higher risk of infection at the site of surgery (27.7% compared to 7.7%, p = 0.002), delay wound healing (15.4% compared to 4.6%, p = 0.03), and developing sepsis (7.7% of the children in the poor nutrition group. They also experienced longer hospital stays (7.4 ± 2.1 days vs. 5.2 ± 1.6 days, p < 0.001) and delayed time to resume oral intake (2.5 ± 0.6 days vs. 1.8 ± 0.4 days, p < 0.001).Specifically, intraoperative difficulties, including increased blood loss and longer operative time, were found more often in malnourished children.
Conclusion: This study revealed that nutritional status affects postoperative morbidity in pediatric surgical patients. ‘It has been observed that poor nutrition is a risk factor for development of complications and longer time to recovery that need for regular nutritional screen and preoperative optimization’. Perioperative nutritional interventions can be effective in enhancing the outcome of surgical operations and decreasing health costs.
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Muhammad Jehangir Khan
Assistant Professor, Department of Paediatric Surgery, Khalifa Gulnawaz Teaching Hospital, Bannu Medical College, Bannu, Pakistan