Analysis of Risk Factors and Construction of A Prediction Model for Postoperative Malnutrition in Children with Congenital Heart Disease
SHI Xiaoman
KONG Xiangying
WEI Wei
LI Zhen
LU Zhen
Abstract：Objective To analyze the risk factors for postoperative malnutrition in children with congenital heart disease(CHD)and construct a prediction model.Methods A total of 226 children with CHD admitted to the First Affiliated Hospital of Nanjing Medical University from April 2021 to March 2023 were retrospectively selected and divided into a malnutrition group(n=81)and a well-nourished group(n=145)based on the presence or absence of postoperative malnutrition.Multivariate logistic regression was used to analyze the influencing factors;a nomogram model for postoperative malnutrition in children with CHD was constructed,and its predictive value was evaluated using the receiver operating characteristic curve.Results The malnutrition group had lower birth weight than the well-nourished group,and the proportions of preterm birth,complex CHD,and RACHS-1 grade 3-4 were higher in the malnutrition group than in the well-nourished group.The durations of cardiopulmonary bypass,mechanical ventilation,ICU stay,and time to initiation of enteral nutrition were longer in the malnutrition group than in the well-nourished group(P<0.05).Multivariate analysis showed that low birth weight(OR=0.435,95%CI:0.298-0.635),preterm birth(OR=2.046,95%CI:1.449-2.889),complex CHD(OR=2.408,95%CI:1.624-3.571),and long cardiopulmonary bypass time(OR=2.702,95%CI:1.762-4.142)were risk factors for postoperative malnutrition in children with CHD(P<0.05).The consistency index of the nomogram model was 0.826(95%CI:0.772-0.880);the calibration curve showed that its slope approached 1.The area under the curve(95%CI)of the nomogram model for predicting postoperative malnutrition in children with CHD was 0.876(0.821-0.929),with a specificity of 68.44%and a sensitivity of 93.26%.Conclusion The influencing factors of postoperative malnutrition in children with CHD include birth weight,preterm birth,type of CHD,and cardiopulmonary bypass time.The nomogram model constructed based on these factors has relatively high predictive accuracy.
Keywords：congenital heart diseasechildrenmalnutritionrisk factorsprediction model
Publication Date：2025-11-20
Online Publishing Date：2025-11-24(First online date of this platform, not the publication date of the document)
Pages：4( 7-10 )