Abstract
Objective
The authors sought to evaluate the role of nutritional indices such as Onodera's prognostic nutrition index (PNI), World Health Organization (WHO)-based anthropometric measurements such as weight for age (w/a), height for age, weight for height, and perioperative serum albumin levels in the determination of postoperative clinical outcomes in pediatric patients who undergo surgery for congenital cardiac defects and surgical complexity (risk-adjusted congenital heart surgery score) and its correlation with postoperative course.
Material and Methods
In this prospective observational study, 108 post-pediatric cardiac surgery patients under the age of 18 months were enrolled between January 2023 and August 2023. Through receiver operating characteristic curve analysis we have found the cutoff value for PNI is ≤66.5 and >66.5. The above mentioned parameters were analyzed for postoperative clinical outcomes such as length of intensive care unit (ICU) stay, length of hospital stay, and duration of mechanical ventilation.
Results
Significant negative correlation was found between length of ICU stay and hospital stay with lower PNI (P = .019 and <.001, respectively.). Analysis of low versus high PNI groups was suggestive of a remarkable increase in mechanical ventilation time (P = .03), length of ICU stay (0.01), and hospital stay (P ≤ .001) in the low PNI group. Lower WHO-based w/a Z score was found to be significantly associated with low PNI (<66.5), after adjusting for preoperative albumin, postoperative albumin drop, and C-reactive protein (odds ratio = 1.411 per unit 0.28 increment in W/azs, P = .004).
Conclusion
Preoperative Onoderas PNI is an effective and efficient tool for predicting postoperative clinical morbidity in pediatric patients undergoing congenital heart surgery.
Keywords
Get full access to this article
View all access options for this article.
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
