The Use of the Perioperative Nutrition Score in Postoperative Pediatric Inflammatory Bowel Disease Patients

Background and objectives: Preoperative malnutrition is associated with increased postoperative morbidity. The perioperative nutrition score (PONS) was developed to identify patients at risk of malnutrition. We sought to assess the correlation between preoperative PONS and postoperative out-comes in pediatric inflammatory bowel disease (IBD) patients. Methods: We performed a retrospective cohort study of IBD patients, less than 21 years of age, who underwent elective bowel resection between June 2018 and November 2021. Patients were divided based upon whether they met PONS criteria. The primary outcome was postoperative surgical site infections. Results: 96 patients were included. Sixty-one patients (64%) met at least one PONS criteria, while 35 patients (36%) met none. PONS positive patients more frequently received preoperative TPN supple-mentation (p < .001). There was no difference in preoperative oral nutritional supplementation between groups. Patients that screened positive for PONS had a longer hospital stay (p = .002), more readmissions (p = .029), and more surgical site infections (p = .002). Conclusions: Our data highlight the prevalence of malnutrition in the pediatric IBD population. Patients who screened positive had worse postoperative outcomes. Further, very few of these patients received preoperative optimization with oral nutritional supplementation. There is a need for standardization of nutritional evaluation to improve preoperative nutritional status and postoperative outcomes. Level of Evidence: III. Type of Study: Retrospective Cohort. (c) 2023 Elsevier Inc. All rights reserved.

Automated summary

This retrospective cohort study assessed the correlation between preoperative perioperative nutrition score (PONS) and postoperative outcomes in pediatric inflammatory bowel disease (IBD) patients. The results showed that PONS positive patients had a higher risk of postoperative infections, longer hospital stays, and more readmissions. This highlights the high prevalence of malnutrition in pediatric IBD patients and the need for standardized nutritional evaluation to improve preoperative nutritional status and postoperative outcomes.