Perioperative nutrition in the setting of pediatric inflammatory bowel disease. Nutr Clin Pract 2024 Feb;39(1):184-192
Date
06/11/2023Pubmed ID
37302062DOI
10.1002/ncp.11021Scopus ID
2-s2.0-85161656389 (requires institutional sign-in at Scopus site)Abstract
BACKGROUND: Optimization of nutrition prior to inflammatory bowel disease (IBD)-related surgery could improve outcomes. The aim of this study was to assess the perioperative nutrition status and management of children undergoing intestinal resection for treatment of their IBD.
METHODS: We identified all patients with IBD who underwent primary intestinal resection. We identified malnutrition using established criteria and methods of nutrition provision at various time points (preoperative outpatient evaluation, admission, and postoperative outpatient follow-up) for elective cases (who underwent their procedure at a scheduled admission) and urgent cases (who underwent an unplanned surgical intervention). We also recorded data on postsurgical complications.
RESULTS: A total of 84 patients were identified in this single-center study (male sex: 40%, mean age: 14.5 years, Crohn's disease: 65%). Thirty-four patients (40%) had some degree of malnutrition. Prevalence of malnutrition in the urgent and elective cohorts was similar (48% vs 36%; P = 0.37). Of these patients, 29 (34%) were noted to be on some type of nutrition supplementation prior to surgery. Postoperatively, BMI z scores increased (-0.61 vs -0.42; P = 0.0008), but the percentage of patients who were malnourished did not change from preoperative status (40% vs 40%; P = 0.10). Despite this, use of nutrition supplementation was only noted in 15 (17%) patients at postoperative follow-up. Complications were not associated with nutrition status.
CONCLUSION: Utilization of supplemental nutrition decreased postprocedure despite no change in malnutrition prevalence. These findings support the development of a pediatric-specific perioperative nutrition protocol in the setting of IBD-related surgery.
Author List
Wong J, Densmore J, Hilbrands J, Elkadri A, Cabrera J, Noe J, Eickhoff J, Goday PSAuthors
John C. Densmore MD Professor in the Surgery department at Medical College of WisconsinAbdul Aziz Elkadri MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Joshua D. Noe MD Associate Dean, Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentChild
Crohn Disease
Humans
Inflammatory Bowel Diseases
Male
Malnutrition
Nutritional Status
Postoperative Complications
Preoperative Care
