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

Space: StayCurrentMD Author: Mitchell R. Ladd, Alejandro V. Garcia, Ira L. Leeds, Courtney Haney, Maria M. Oliva-Hemker, Samuel Alaish, Emily Boss, Daniel S. Rhee Published:

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Mitchell R. Ladd, Alejandro V. Garcia, Ira L. Leeds, Courtney Haney, Maria M. Oliva-Hemker, Samuel Alaish, Emily Boss, Daniel S. Rhee

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Abstract

Background

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.

Study design

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.

Results

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 

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