Aim To determine whether biochemical nutritional indices predict clinical outcomes in children undergoing cardiac surgery.
Methods Retrospective single centre study between July 2012 and June 2013. Biochemical nutritional indices included serum albumin and total lymphocyte count (TLC) which was used to calculate Onodera’s prognostic nutritional index (PNI) [10 x serum albumin (g/dL) + 0.005 x TLC (/mL)]. Severity of illness assessed using Paediatric Risk of Mortality (PRISM) III score. Surgery categorised using the risk adjusted classification for congenital heart surgery (RACHS-1) score. Outcomes included hospital mortality, paediatric intensive care unit (PICU) length of stay (LOS) and duration of mechanical ventilation (MV).
Results Total of 31 patients identified. Median age was 2.0 (0.7–41.0) months. Median PRISM III score was 8.0 (5.0–13.0). 14 (45%) underwent RACHS-1 category 2 surgery and 6 (20%) had ventricular septal defects. Median albumin and TLC were 3.2 (2.6–4.2) g/dL and 4280 (2810–5100)/uL respectively. Median PNI score was 52.7 (41.2–69.7). There was no hospital mortality. Median PICU LOS was 5.0 (3.0–8.0) days. Hypoalbuminaemia ≤3.0 g/dL associated with longer median PICU LOS (7.0 vs. 4.0 days, p = 0.016) and duration of MV (156 vs. 33 h, p = 0.007). PNI ≤ 58 associated with longer median PICU LOS (6.0 vs. 3.0 days, p = 0.041). Adjusting for age and RACHS-1 score, for every 1 g/dL drop in albumin, PICU LOS increased by 0.5 days (p = 0.006).
Conclusions Hypoalbuminaemia and PNI ≤ 58 were associated with adverse postoperative outcomes. Future studies to study effect of perioperative aggressive nutrition care on biochemical indices and clinical outcomes.