Preoperative nutrition status in children with congenital heart disease and its impact on postoperative outcomes: a systematic review and meta-analysis
Abstract Despite the significant advancement in congenital heart disease (CHD) surgery over the years, the mortality and morbidity rate in children undergoing CHD surgery is substantial, especially in lower-middle-income countries. Evidence shows that malnutrition contributes to morbidity and mortal...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-07-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-025-96374-z |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849766158127857664 |
|---|---|
| author | Qalab Abbas Haider Ali Akash Kumar Ahuja Omaima Anis Bhatti Shamila Ladak Iraj Khan Abdul Rehman Shazia Mohsin Ibrahim Shah Aneela Ilyas Laila Akbar Ladak |
| author_facet | Qalab Abbas Haider Ali Akash Kumar Ahuja Omaima Anis Bhatti Shamila Ladak Iraj Khan Abdul Rehman Shazia Mohsin Ibrahim Shah Aneela Ilyas Laila Akbar Ladak |
| author_sort | Qalab Abbas |
| collection | DOAJ |
| description | Abstract Despite the significant advancement in congenital heart disease (CHD) surgery over the years, the mortality and morbidity rate in children undergoing CHD surgery is substantial, especially in lower-middle-income countries. Evidence shows that malnutrition contributes to morbidity and mortality in these children, with a negative impact on their surgical outcomes. The aim of this systematic review and meta-analysis was to assess the impact of preoperative nutritional status on postoperative outcomes among patients with CHD. PubMed, Embase, Scopus, CINAHL, ProQuest, and the Cochrane Library were searched from January 1, 2000, to Mar 1, 2024. Twenty-one studies were included in the review with 22,621 malnourished and 60,402 well-nourished children undergoing CHD surgery. Malnourished children had a significantly longer LOS in the hospital, with a standard mean difference (SMD) of 0.49 [95% confidence interval (CI) 0.09–0.88] days, a longer ICU stay (SMD 0.51 [95% CI 0.16–0.86] days), a higher RACHS-1/STAT score (SMD 1.72 [95% CI 1.32–2.25]), and a higher mechanical ventilation time (SMD 0.46 [95% CI 0.18–0.74] hours). However, there was no significant difference in mortality, with an odds ratio (OR) of 1.82 [95% CI 0.94–3.5], and postoperative infection rates (OR 1.27 [95% CI 0.05–35.02]) between the malnourished and well-nourished groups. Malnourished children undergoing CHD surgery experience significantly worse postoperative outcomes in terms of hospital and ICU stay, and mechanical ventilation time. Efforts to improve preoperative nutritional status could potentially enhance these outcomes. |
| format | Article |
| id | doaj-art-0bc0113bba7f4805b0b02e590fb3fb63 |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-0bc0113bba7f4805b0b02e590fb3fb632025-08-20T03:04:39ZengNature PortfolioScientific Reports2045-23222025-07-0115111910.1038/s41598-025-96374-zPreoperative nutrition status in children with congenital heart disease and its impact on postoperative outcomes: a systematic review and meta-analysisQalab Abbas0Haider Ali1Akash Kumar Ahuja2Omaima Anis Bhatti3Shamila Ladak4Iraj Khan5Abdul Rehman6Shazia Mohsin7Ibrahim Shah8Aneela Ilyas9Laila Akbar Ladak10Department of Pediatrics and Child Health, The Aga Khan University HospitalDepartment of Pediatrics and Child Health, The Aga Khan University HospitalMedical College, The Aga Khan UniversityMedical College, The Aga Khan UniversityMedical College, The Aga Khan UniversityMedical College, The Aga Khan UniversityDepartment of Biological and Biomedical Sciences, The Aga Khan UniversityDepartment of Cardiovascular Sciences, Sindh Institute of Urology and TransplantationSchool of Nursing and Midwifery, The Aga Khan UniversitySchool of Nursing and Midwifery, The Aga Khan UniversityDepartment of Pediatrics and Child Health, The Aga Khan University HospitalAbstract Despite the significant advancement in congenital heart disease (CHD) surgery over the years, the mortality and morbidity rate in children undergoing CHD surgery is substantial, especially in lower-middle-income countries. Evidence shows that malnutrition contributes to morbidity and mortality in these children, with a negative impact on their surgical outcomes. The aim of this systematic review and meta-analysis was to assess the impact of preoperative nutritional status on postoperative outcomes among patients with CHD. PubMed, Embase, Scopus, CINAHL, ProQuest, and the Cochrane Library were searched from January 1, 2000, to Mar 1, 2024. Twenty-one studies were included in the review with 22,621 malnourished and 60,402 well-nourished children undergoing CHD surgery. Malnourished children had a significantly longer LOS in the hospital, with a standard mean difference (SMD) of 0.49 [95% confidence interval (CI) 0.09–0.88] days, a longer ICU stay (SMD 0.51 [95% CI 0.16–0.86] days), a higher RACHS-1/STAT score (SMD 1.72 [95% CI 1.32–2.25]), and a higher mechanical ventilation time (SMD 0.46 [95% CI 0.18–0.74] hours). However, there was no significant difference in mortality, with an odds ratio (OR) of 1.82 [95% CI 0.94–3.5], and postoperative infection rates (OR 1.27 [95% CI 0.05–35.02]) between the malnourished and well-nourished groups. Malnourished children undergoing CHD surgery experience significantly worse postoperative outcomes in terms of hospital and ICU stay, and mechanical ventilation time. Efforts to improve preoperative nutritional status could potentially enhance these outcomes.https://doi.org/10.1038/s41598-025-96374-zMalnutritionPediatric ICULength of stayMechanical ventilationMortalityPostoperative infection |
| spellingShingle | Qalab Abbas Haider Ali Akash Kumar Ahuja Omaima Anis Bhatti Shamila Ladak Iraj Khan Abdul Rehman Shazia Mohsin Ibrahim Shah Aneela Ilyas Laila Akbar Ladak Preoperative nutrition status in children with congenital heart disease and its impact on postoperative outcomes: a systematic review and meta-analysis Scientific Reports Malnutrition Pediatric ICU Length of stay Mechanical ventilation Mortality Postoperative infection |
| title | Preoperative nutrition status in children with congenital heart disease and its impact on postoperative outcomes: a systematic review and meta-analysis |
| title_full | Preoperative nutrition status in children with congenital heart disease and its impact on postoperative outcomes: a systematic review and meta-analysis |
| title_fullStr | Preoperative nutrition status in children with congenital heart disease and its impact on postoperative outcomes: a systematic review and meta-analysis |
| title_full_unstemmed | Preoperative nutrition status in children with congenital heart disease and its impact on postoperative outcomes: a systematic review and meta-analysis |
| title_short | Preoperative nutrition status in children with congenital heart disease and its impact on postoperative outcomes: a systematic review and meta-analysis |
| title_sort | preoperative nutrition status in children with congenital heart disease and its impact on postoperative outcomes a systematic review and meta analysis |
| topic | Malnutrition Pediatric ICU Length of stay Mechanical ventilation Mortality Postoperative infection |
| url | https://doi.org/10.1038/s41598-025-96374-z |
| work_keys_str_mv | AT qalababbas preoperativenutritionstatusinchildrenwithcongenitalheartdiseaseanditsimpactonpostoperativeoutcomesasystematicreviewandmetaanalysis AT haiderali preoperativenutritionstatusinchildrenwithcongenitalheartdiseaseanditsimpactonpostoperativeoutcomesasystematicreviewandmetaanalysis AT akashkumarahuja preoperativenutritionstatusinchildrenwithcongenitalheartdiseaseanditsimpactonpostoperativeoutcomesasystematicreviewandmetaanalysis AT omaimaanisbhatti preoperativenutritionstatusinchildrenwithcongenitalheartdiseaseanditsimpactonpostoperativeoutcomesasystematicreviewandmetaanalysis AT shamilaladak preoperativenutritionstatusinchildrenwithcongenitalheartdiseaseanditsimpactonpostoperativeoutcomesasystematicreviewandmetaanalysis AT irajkhan preoperativenutritionstatusinchildrenwithcongenitalheartdiseaseanditsimpactonpostoperativeoutcomesasystematicreviewandmetaanalysis AT abdulrehman preoperativenutritionstatusinchildrenwithcongenitalheartdiseaseanditsimpactonpostoperativeoutcomesasystematicreviewandmetaanalysis AT shaziamohsin preoperativenutritionstatusinchildrenwithcongenitalheartdiseaseanditsimpactonpostoperativeoutcomesasystematicreviewandmetaanalysis AT ibrahimshah preoperativenutritionstatusinchildrenwithcongenitalheartdiseaseanditsimpactonpostoperativeoutcomesasystematicreviewandmetaanalysis AT aneelailyas preoperativenutritionstatusinchildrenwithcongenitalheartdiseaseanditsimpactonpostoperativeoutcomesasystematicreviewandmetaanalysis AT lailaakbarladak preoperativenutritionstatusinchildrenwithcongenitalheartdiseaseanditsimpactonpostoperativeoutcomesasystematicreviewandmetaanalysis |