Malnutrition increases the risk of 30-day complications after surgery in pediatric patients with Crohn disease

Journal of Pediatric Surgery
Mitchell R LaddDaniel S Rhee

Abstract

Pediatric patients with Crohn disease (CD) are frequently malnourished, yet how this affects surgical outcomes has not been evaluated. This study aims to determine the effects of malnourishment in children with CD on 30-day outcomes after surgery. The ACS NSQIP-Pediatric database from 2012 to 2015 was used to select children aged 5-18 with CD who underwent bowel surgery. BMI-for-age Z-scores were calculated based on CDC growth charts and 2015 guidelines of pediatric malnutrition were applied to categorize severity of malnutrition into none, mild, moderate, or severe. Malnutrition's effects on 30-day complications. Propensity weighted multivariable regression was used to determine the effect of malnutrition on complications were evaluated. 516 patients were included: 349 (67.6%) without malnutrition, 97 (18.8%) with mild, 49 (9.5%) with moderate, and 21 (4.1%) with severe malnutrition. There were no differences in demographics, ASA class, or elective/urgent case type. Overall complication rate was 13.6% with malnutrition correlating to higher rates: none 9.7%, mild 18.6%, moderate 20.4%, and severe 28.6% (p < 0.01). In propensity-matched, multivariable analysis, malnutrition corresponded with increased odds of complications in m...Continue Reading

Citations

May 11, 2019·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Kris M MogensenUNKNOWN Malnutrition Committee of the American Society for Parenteral and Enteral Nutrition (ASPEN)
Nov 30, 2019·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·T YamamotoS Umegae
Oct 31, 2020·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·David C EvansUNKNOWN ASPEN Malnutrition Committee
May 21, 2019·Journal of Pediatric Surgery·Angela M KaoAndrew M Schulman
Nov 17, 2020·Journal of Pediatric Surgery·Mya L RobersonMichael R Phillips
Oct 19, 2020·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·C WallonA De Luca
Nov 15, 2020·Journal of the Academy of Nutrition and Dietetics·Wendy PhillipsJenni Carvalho-Salemi
May 29, 2021·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Mohammad KermansaraviSonja Chiappetta
Jul 30, 2021·Journal of Pediatric Gastroenterology and Nutrition·Matthew D EgbergMichael D Kappelman

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