Weight gain and triceps skinfolds fat mass after gastrostomy placement in children with developmental disabilities.
OBJECTIVE
To determine appropriate outcome indicators of nutritional status that are measurable over time after gastrostomy placement in children with severe neurologic impairments.


METHODS
Twenty-two nonambulatory children met the selection criteria: feeding by gastrostomy of at least 50% of total energy, age between 1 and 12 years, diagnosis of neurologic impairments, and presurgical recommendation for weight gain. Each child served as his or her own control; three assessments were made after gastrostomy placement.


METHODS
Children were seen in specialty outpatient clinics.


METHODS
Scores and Pearson product moment correlations.


RESULTS
Outcomes of gastrostomy placement were (a) increase in actual weight, (b) increase in weight-age equivalent, (c) rate of weight accretion as expected by National Center for Health Statistics growth charts and improved z scores for half of the children, and (d) improvement in triceps skinfolds percentiles for nearly half (n = 10) of the children. The results reflect the heterogeneity of children with severe disabilities. Pearson correlations showed a significant relationship between chronologic age and weight-age equivalent (r = .96), but not for weight for age and weight-age equivalent, or triceps skinfolds fat mass and weight-age equivalent.


CONCLUSIONS
Weight and triceps skinfolds fat mass were appropriate outcome indicators of nutritional status measurable over time. Weight-age equivalent and z scores were more helpful than standard growth plots for interpreting weight gain over time. Our data also support findings that undernutrition limits growth before gastrostomy placement in patients with disabilities. Nutritionists are encouraged to track improvement in nutritional status after gastrostomy placement with measurements of triceps skinfolds fat mass and to use the information to support families facing decisions about the need for this surgery.
Isaacs
J S
JS
Department of Nutrition Sciences, Civitan International Research Center, University of Alabama at Birmingham 35294.
Georgeson
K E
KE
Cloud
H H
HH
Woodall
N
N
D000273:Adipose Tissue / Q000254:growth & development; D000886:Anthropometry; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000378:metabolism* / Q000601:surgery / Q000628:therapy; D004750:Enteral Nutrition; D005774:Gastrostomy; D006128:Growth; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D009128:Muscle Spasticity; D009752:Nutritional Status; D011446:Prospective Studies; D011782:Quadriplegia / Q000378:metabolism / Q000601:surgery / Q000628:therapy; D012885:Skinfold Thickness; D016896:Treatment Outcome; D015430:Weight Gain