Nutritional status and clinical outcomes of brain tumor surgery in pediatric intensive care unit: A prospective cohort study

Clin Nutr ESPEN. 2024 Jun:61:302-307. doi: 10.1016/j.clnesp.2024.03.029. Epub 2024 Apr 2.

Abstract

Background: To determine whether nutritional status affects mortality and length of stay in the pediatric intensive care unit (PICU) after brain tumor surgery.

Methods: Subjects aged 2 months to 13 years with brain tumor surgery were included in the study. Z-scores of BMI for age, weight for age, and weight for length were calculated at admission. Undernutrition was defined as Z-score < -2. Nutritional intake was measured daily by a clinical nutritionist. Outcomes to be measured included duration of hospitalization and mortality. Regression analyses was used to investigate the relationship between nutritional variables and outcomes.

Results: A total of 63 patients met the inclusion criteria. Undernutrition at admission was found in 33% of subjects based on Z-scores of BMI and weight for length. The mortality rate was 17.5%. Calorie and protein intake was <50% of the target in 50.7% and 42.8 % of children, respectively. Undernutrition by weight for age Z-score, BMI for age and weight for length Z-scores, and low protein intake increased mortality risk by 5, 5.9 and 4.7 times, respectively. The risk of shorter PICU-free days was independently 80% and 90% lower in those receiving <50% of protein and calorie requirements.

Conclusion: Undernutrition at admission is prevalent in children undergoing brain tumor surgery and is associated with a higher risk of mortality. Caloric and protein intake during hospitalization is generally low, leading to longer PICU stay.

Keywords: Malnutrition; Mortality; Nutritional status; PICU; PIM2.

MeSH terms

  • Adolescent
  • Body Mass Index*
  • Body Weight
  • Brain Neoplasms* / surgery
  • Child
  • Child, Preschool
  • Energy Intake*
  • Female
  • Humans
  • Infant
  • Intensive Care Units, Pediatric*
  • Length of Stay*
  • Male
  • Malnutrition*
  • Nutrition Assessment
  • Nutritional Status*
  • Prospective Studies
  • Treatment Outcome