title: Malnutrition in children with congenital heart disease (CHD) determinants and short term impact of corrective intervention.
abstract: OBJECTIVE
  To identify determinants of malnutrition in children with congenital heart disease (CHD) and examine the short-term effects of corrective intervention.
  
  
  METHODS
  Patients with CHD admitted for corrective intervention were evaluated for nutritional status before and 3 months after surgery. Detailed anthropometry was performed and z-scores calculated. Malnutrition was defined as weight, height and weight/height z-score <or= -2. Determinants of malnutrition were entered into a multivariate logistic regression analysis model.
  
  
  RESULTS
  476 consecutive patients undergoing corrective intervention were included. There were 16 deaths (3.4%; 13 in-hospital, 3 follow-up). The 3-month follow-up data of 358 (77.8%) of remaining 460 patients were analyzed. Predictors of malnutrition at presentation are as summarized: weight z-score <or= -2 (59%): congestive heart failure (CHF), age at correction, lower birth weight and fat intake, previous hospitalizations, >or= 2 children; height z-score <or= -2 (26.3%): small for gestation, lower maternal height and fat intake, genetic syndromes; and weight/height z-score <or= -2 (55.9%): CHF, age at correction, lower birthweight and maternal weight, previous hospitalizations, religion (Hindu) and level of education of father. Comparison of z-scores on 3-month follow-up showed a significant improvement from baseline, irrespective of the cardiac diagnosis.
  
  
  CONCLUSIONS
  Malnutrition is common in children with CHD. Corrective intervention results in significant improvement in nutritional status on short-term follow-up.
authors.affiliation: Department of Pediatric Cardiology, Amrita Institute of Medical Sciences and Research Center, Elamakkara P.O., Kochi, Kerala 682 026, India. baluvaidyanathan@gmail.com
authors.forename: Balu
authors.initials: B
authors.lastname: Vaidyanathan
authors.forename: Sreeparvathy B
authors.initials: SB
authors.lastname: Nair
authors.forename: K R
authors.initials: KR
authors.lastname: Sundaram
authors.forename: Uma K
authors.initials: UK
authors.lastname: Babu
authors.forename: K
authors.initials: K
authors.lastname: Shivaprakasha
authors.forename: Suresh G
authors.initials: SG
authors.lastname: Rao
authors.forename: R Krishna
authors.initials: RK
authors.lastname: Kumar
mesh_terms: D003710:Demography; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D044342:Malnutrition / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors