Prospective Study of the Impact of Preoperative Nutrition on Postoperative Outcomes in Paediatric Surgery Using a Novel Two-axis Classification Scheme

• Published in: Journal of Indian Association of Pediatric Surgeons Vol. 30; no. 1; pp. 14 - 21
• Main Authors: Chacko, Benjamin, Zameer, M. M., Vinay, D'cruz, Ashley L. J., Rao, Sanjay
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer - Medknow 2025; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer Medknow Publications
• Edition: 2
• Subjects: Analysis; Anthropometry; Award Papers IAPSCON; Children; Childrens health; Classification schemes; Health aspects; Medical research; Medicine, Experimental; Nutrition; nutritional assessment; Overweight; pediatric surgery; Pediatrics; postoperative outcomes; Product/Service Evaluations; Surgery; Surgical outcomes; two-axis scheme; United States; Nutritional assessment; postoperative outcomes; pediatric surgery; two-axis scheme
• ISSN: 0971-9261; 1998-3891
• DOI: 10.4103/jiaps.jiaps_150_24

ABSTRACT Background: Malnutrition is a significant concern in the hospitalized surgical cohort. Despite this there is no standardized scheme tailored for the pediatric surgical cohort. This study evaluated the feasibility to of the novel two-axis scheme to fill the lacunae in pediatric nutritional assessment. Aims: The aim of this study is to study the effect of the preoperative nutritional status on the clinical outcomes. Materials and Methods: This is a prospective, observational, and cohort study of all pediatric patients undergoing surgery at our center from January 2021 to September 2022. Preoperative anthropometry was measured and all subjects were classified using the two-axis scheme incorporating body mass index and height z-scores into nonoutliers or one of the four outlier groups: underweight short, underweight tall, overweight short, and overweight tall. All complications within 30 days postsurgery were recorded and graded by the Clavien-Dindo classification. Results: The study included a total of 827 patients who underwent 1022 surgeries, 70.5% being males. About 33% of the cohort was under 5 years of age. Overall incidence of complications was 10.1% with underweight short group having the highest (19.7%). Underweight short group had higher incidence of composite and healthcare-associated infections (P < 0.05) and higher odds of all types of complication in comparison to the nonoutliers. No significant relation was noted between the nutritional groups and the severity of the complication. Conclusions: This study supported the predictive value and feasibility of this novel two-axis nutritional classification scheme in the pediatric surgical outcomes. The underweight short subjects are at higher risk of developing postoperative complications.