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Risk factors of malnutrition in Chinese children with congenital heart defect

BACKGROUND: The study aimed to investigate the risk factors of malnutrition in children with congenital heart defect (CHD) in China. METHODS: This cohort study was performed at the biggest pediatric heart center in China; 3252 patients with CHD who underwent cardiac surgeries in 2013 were included....

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Autores principales: Zhang, Mingjie, Wang, Liping, Huang, Rui, Sun, Chongrui, Bao, Nan, Xu, Zhuoming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218652/
https://www.ncbi.nlm.nih.gov/pubmed/32404077
http://dx.doi.org/10.1186/s12887-020-02124-7
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author Zhang, Mingjie
Wang, Liping
Huang, Rui
Sun, Chongrui
Bao, Nan
Xu, Zhuoming
author_facet Zhang, Mingjie
Wang, Liping
Huang, Rui
Sun, Chongrui
Bao, Nan
Xu, Zhuoming
author_sort Zhang, Mingjie
collection PubMed
description BACKGROUND: The study aimed to investigate the risk factors of malnutrition in children with congenital heart defect (CHD) in China. METHODS: This cohort study was performed at the biggest pediatric heart center in China; 3252 patients with CHD who underwent cardiac surgeries in 2013 were included. Anthropometric measurements included weight for age Z score (WAZ), weight for height Z score (WHZ), and height for age Z score (HAZ). The patients were classified as normal nutritional status and malnutrition, based on a cut-off Z score of <− 2. Factors associated with malnutrition were determined using logistic regression analysis. RESULTS: The prevalence of preoperative WAZ < -2 (underweight), HAZ < -2 (stunting), and WHZ < -2 (wasting) was 23.3, 23.3, and 14.3%, respectively. The multivariable analysis of preoperative malnutrition showed that hospitalization, age at surgery, risk adjustment for congenital heart surgery-1 > 3, mechanical ventilation, pulmonary hypertension, and acyanotic heart disease were associated with underweight. Parents’ height, single ventricle, and cyanotic heart disease were associated with stunting. Hospitalization and pulmonary hypertension were associated with wasting. After surgery, the patients presented a significant improvement in growth within the first year in all three parameters and grew to the normal range of WAZ (− 0.3 ± 0.9, P < 0.001), HAZ (0.2 ± 0.8, P = 0.001), and WHZ (0.03 ± 0.6, P < 0.001) at 2 years after surgery. The prevalence of underweight, stunted, and wasting declined to 3.2, 2.7, and 1.9% 3 years after surgery. Malnutrition after surgery was associated with cardiac residual cardiac abnormalities (OR = 35.3, p < 0.0001), high Ross classification of heart function (OR = 27.1, p < 0.0001), and long-term taking oral diuretics (OR = 20.5, P = 0.001). CONCLUSIONS: Malnutrition is still a problem in children with CHD in China, especially before the surgery. There is need to strengthen the nutrition support for children with CHD before surgery. Hemodynamic factors were found to be the risk factors associated with malnutrition after operation.
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spelling pubmed-72186522020-05-20 Risk factors of malnutrition in Chinese children with congenital heart defect Zhang, Mingjie Wang, Liping Huang, Rui Sun, Chongrui Bao, Nan Xu, Zhuoming BMC Pediatr Research Article BACKGROUND: The study aimed to investigate the risk factors of malnutrition in children with congenital heart defect (CHD) in China. METHODS: This cohort study was performed at the biggest pediatric heart center in China; 3252 patients with CHD who underwent cardiac surgeries in 2013 were included. Anthropometric measurements included weight for age Z score (WAZ), weight for height Z score (WHZ), and height for age Z score (HAZ). The patients were classified as normal nutritional status and malnutrition, based on a cut-off Z score of <− 2. Factors associated with malnutrition were determined using logistic regression analysis. RESULTS: The prevalence of preoperative WAZ < -2 (underweight), HAZ < -2 (stunting), and WHZ < -2 (wasting) was 23.3, 23.3, and 14.3%, respectively. The multivariable analysis of preoperative malnutrition showed that hospitalization, age at surgery, risk adjustment for congenital heart surgery-1 > 3, mechanical ventilation, pulmonary hypertension, and acyanotic heart disease were associated with underweight. Parents’ height, single ventricle, and cyanotic heart disease were associated with stunting. Hospitalization and pulmonary hypertension were associated with wasting. After surgery, the patients presented a significant improvement in growth within the first year in all three parameters and grew to the normal range of WAZ (− 0.3 ± 0.9, P < 0.001), HAZ (0.2 ± 0.8, P = 0.001), and WHZ (0.03 ± 0.6, P < 0.001) at 2 years after surgery. The prevalence of underweight, stunted, and wasting declined to 3.2, 2.7, and 1.9% 3 years after surgery. Malnutrition after surgery was associated with cardiac residual cardiac abnormalities (OR = 35.3, p < 0.0001), high Ross classification of heart function (OR = 27.1, p < 0.0001), and long-term taking oral diuretics (OR = 20.5, P = 0.001). CONCLUSIONS: Malnutrition is still a problem in children with CHD in China, especially before the surgery. There is need to strengthen the nutrition support for children with CHD before surgery. Hemodynamic factors were found to be the risk factors associated with malnutrition after operation. BioMed Central 2020-05-13 /pmc/articles/PMC7218652/ /pubmed/32404077 http://dx.doi.org/10.1186/s12887-020-02124-7 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Zhang, Mingjie
Wang, Liping
Huang, Rui
Sun, Chongrui
Bao, Nan
Xu, Zhuoming
Risk factors of malnutrition in Chinese children with congenital heart defect
title Risk factors of malnutrition in Chinese children with congenital heart defect
title_full Risk factors of malnutrition in Chinese children with congenital heart defect
title_fullStr Risk factors of malnutrition in Chinese children with congenital heart defect
title_full_unstemmed Risk factors of malnutrition in Chinese children with congenital heart defect
title_short Risk factors of malnutrition in Chinese children with congenital heart defect
title_sort risk factors of malnutrition in chinese children with congenital heart defect
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218652/
https://www.ncbi.nlm.nih.gov/pubmed/32404077
http://dx.doi.org/10.1186/s12887-020-02124-7
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