Nutritional status and risk factors for malnutrition in children with single ventricle physiology after total cavopulmonary connection / 上海交通大学学报（医学版）

ABSTRACT

Objective: To analyse nutritional status of children underwent total cavopulmonary connection (TCPC) also called Fontan procedure, furthermore to investigate risk factors related to malnutrition including underweight, stunting, and thinness. Methods: Clinical data of 314 children underwent Fontan procedure in Shanghai Children's Medical Center from Jan. 2012 to Dec. 2015 were reviewed. WHO Z score was used to evaluate nutritional status of the children underwent Fontan procedure at the time of long-term follow-up. According to the nutritional status, children were divided into underweight and no-underweight groups, stunting and no-stunting groups, thinness and no-thinness groups. Univariate and multivariate Logistic regression analysis were used to detect risk factors for malnutrition in the children after Fontan procedure. Results: In the follow-up survey after Fontan procedure, the proportion of underweight, stunted and thin children were 11.9%, 17.8%, and 16.9%, respectively. Multivariate Logistic regression analysis showed that preoperative malnutrition, worse cardiac function, moderate or severe atrioventricular valve regurgitation and long time use of diuretics were the risk factors for underweight in the children after Fontan procedure (P=0.008, P=0.000, P=0.025, P=0.001); preoperative malnutrition, elevated mean pulmonary artery pressure, worse cardiac function, moderate or severe atrioventricular valve regurgitation and long time use of diuretics were the risk factors for stunting in the children after Fontan procedure (P=0.001, P=0.046, P=0.000, P=0.019, P=0.004); preoperative malnutrition, elevated mean pulmonary artery pressure, worse cardiac function, moderate or severe atrioventricular valve regurgitation and long time use of diuretics were the risk factors for thinness in the children after Fontan procedure (P=0.019, P=0.018, P=0.015, P=0.026, P=0.000). Conclusion: Malnutrition is still remained during follow-up period in the children with single ventricle physiology after Fontan procedure. Preoperative malnutrition, worse cardiac function, elevated pulmonary artery pressure, long time use of diuretics and moderate or severe atrioventricular valve regurgitation may be associated with malnutrition after Fontan procedure.