Malnutrition in Hospitalized Children With Congenital Heart Disease

Abstract

OBJECTIVE: To determine the prevalence of malnutrition among hospitalized children with congenital heart disease by age, disease process, and clinical status. DESIGN: Cross-sectional, retrospective chart review. SETTING: Pediatric cardiology units at a 150-bed tertiary care teaching hospital in Ann Arbor, Mich. PATIENTS: Patients (n = 160) were randomly selected from consecutive admissions to the Pediatric Cardiology and Thoracic Surgery Services during a 1-year period. INTERVENTION: None. MAIN OUTCOME MEASURES: Acute and chronic malnutrition, assessed by comparing the patients' weight and height with established means. RESULTS: Acute and chronic malnutrition occurred in 33% and 64% of the patients, respectively. Age, diagnostic category, and symptoms were associated with malnutrition. Eighty percent of infants presented with acute malnutrition compared with 18% of patients of other ages (P < .001). Malnutrition affected 60% of patients with left-to-right shunts, 53% of patients with complex heart disease, and no patients with primary rhythm disturbances. Acute malnutrition affected 11% and chronic malnutrition affected 50% of patients with left-sided heart obstruction. Acute or chronic malnutrition occurred in 70% or more of patients with cyanosis and/or congestive heart failure but in only 30% of patients with neither (P < .001). CONCLUSION: Malnutrition in hospitalized children with congenital heart disease remains common, highlighting the importance of nutritional screening and intervention.