Associations between anthropometric indices and outcomes of congenital heart operations in infants and Young children: An analysis of data from the Society of Thoracic Surgeons database

Abstract Background Children with congenital heart disease are at risk for growth failure due to inadequate nutrient intake and increased metabolic demands. We examined the relationship between anthropometric indices of nutrition [height-for-age z-score (HAZ), weight-for-age z-score (WAZ), weight-for-height z-score (WHZ)] and outcomes in a large sample of children undergoing surgery for congenital heart disease. Methods Patients in the Society of Thoracic Surgeons Congenital Heart Surgery Database having index cardiac surgery at age 1 mo to 10 years were included. Indices were calculated by comparing patients' weight and height to population norms from the WHO and CDC. Outcomes included operative mortality, composite mortality or major complication, major post-operative infection, and postoperative length of stay (PLOS). For each outcome and index, the adjusted odds ratio (aOR) (for mortality, composite outcome, and infection) and adjusted relative change in median (for PLOS) for a 1 unit decrease in index was estimated using mixed effects logistic and loglinear regression models. Results Every unit decrease in HAZ was associated with 1.40 aOR of mortality (95% CI 1.32–1.48) and every unit decrease in WAZ was associated with 1.33 aOR for mortality (95% CI 1.25–1.41). The relationship between WHZ and outcome was nonlinear with aOR of mortality of 0.84 (95% CI 0.76–0.93) for 1-unit decrease when WHZ > = 0, and a nonsignificant association for WHZ Conclusions Lower HAZ and WAZ, suggestive of malnutrition, are associated with increased mortality and other adverse outcomes after cardiac surgery in infants and young children. Higher WHZ over zero, suggestive of obesity, is also associated with adverse outcomes.