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Publisher : Indian Pediatrics
Year : 2008
Abstract : Objective: To identify determinants of malnutrition in children with congenital heart disease (CHD) and examine the short-term effects of corrective intervention. Methods: Patients with CHD admitted for corrective intervention were evaluated for nutritional status before and 3 months after surgery. Detailed anthropometry was performed and z-scores calculated. Malnutrition was defined as weight, height and weight/height z-score ≤ -2. Determinants of malnutrition were entered into a multivariate logistic regression analysis model. Results: 476 consecutive patients undergoing corrective intervention were included. There were 16 deaths (3.4%; 13 in-hospital, 3 follow-up). The 3-month follow-up data of 358 (77.8%) of remaining 460 patients were analyzed. Predictors of malnutrition at presentation are as summarized: weight z-score ≤ -2 (59%): congestive heart failure (CHF), age at correction, lower birth weight and fat intake, previous hospitalizations , ≥ 2 children; height z-score ≤ -2 (26.3%): small for gestation, lower maternal height and fat intake, genetic syndromes; and weight/height z-score ≤ -2 (55.9%): CHF, age at correction, lower birth weight and maternal weight, previous hospitalizations, religion (Hindu) and level of education of father. Comparison of z-scores on 3-month follow-up showed a significant improvement from baseline, irrespective of the cardiac diagnosis. Conclusions: Malnutrition is common in children with CHD. Corrective intervention results in significant improvement in nutritional status on short-term follow-up.