AUTHOR=Die Xiaohong , Feng Wei , Song Aohua , Liu Wei , Wang Yi , Guo Zhenhua , He Dawei 

TITLE=Risk factors and simple scoring system for predicting postoperative nutritional status of Hirschsprung’s disease

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2024.1441104

DOI=10.3389/fnut.2024.1441104

ISSN=2296-861X

ABSTRACT=Background Nutritional problem after surgery for Hirschprung's disease (HSCR) was not optimistic. This study aimed to analyze the risk factors of postoperative undernutrition for patients with HSCR and establish a scoring system for predicting postoperative undernutrition.Methods Retrospective review of 341 patients with HSCR who received Laparoscopic-assisted pull-through surgery in a tertiary-level pediatric hospital was conducted with assessments of clinical data.Univariate/multivariate Logistic regression analysis was used to identify independent factors of postoperative undernutrition, and establish a scoring system for predicting postoperative nutritional status based on the sum of adjusted odds ratios (ORs).The postoperative undernutrition of 341 patients with HSCR was 29.9%. Multivariate Logistic regression analysis showed that non-breast feeding (mixed: OR=6.116, artificial: OR=12.00), preoperative undernutrition (risk of malnutrition: OR=7.951, malnutrition: OR=8.985), non-parental caregivers (OR=3.164), long-segment HSCR (OR=12.820), postoperative complications within 30 days (grade 1~2: OR=2.924, Grade 3~4: OR=6.249), and surgery for other systemic malformation (OR=5.503) were risk factors for postoperative undernutrition (all P<0.05), and scoring system was developed based on these determinants. The area under the receiver operator characteristic curve of the derivation sample was 0.887 (95% confidence interval [CI]: 0.839 -0.934) and that of the validation sample was 0.846 (95% CI: 0.772~0.920) with the optimal cut-off value of 12; calibration curves of the derivation sample showed considerable predictive performance for postoperative undernutrition.Conclusions Risk factors identified affecting postoperative undernutrition should be taken seriously in patients with HSCR. We successfully developed a desirable scoring system to predict postoperative nutritional status, which might be helpful for clinical practice.