Background. The relationship between congenital heart disease (CHD) among children and growth retardation is well documented among pediatric patients. However, the extent of growth impairment does not always correlate well with severity of the cardiac lesion or the degree of the left-to-right shunts among patients with VSD or PDA. It is the objective of this study to determine the correlation, association and whether the occurrence of malnutrition can be predicted from the VSD/PDA shunt size defect.
Methodology. This descriptive study included ninety (90) children VSD or PDA admitted at the Philippine Heart Center from October 1, 1999 to September 30, 2000. Charts from the record section were reviewed and patients' data were tabulated. The correlation (Pearson correlation coefficient) and how strong the relationships (coefficient of determination) between the PSD/PDA shunt size defect and the patients' weight/height were determined. 42 analysis was used to determine whether VSD/PDA shunt size defect was used the model to predict the occurrence of malnutrition. VSD/PDA shunt size defect was used in the model to predict the occurrence of malnutrition among patients with CHD using logistic regression. The risk estimate and its 95% confidence interval were likewise determined using SPSS version 9.
Results. Both weight (r=-0.41, p>0.001) and height (r=-0.43, p<0.001) are fairly and negatively correlated with the shunt size defect. Only 17% of the patients' weight and 18% of the height can be accounted for by the size of the VSD/PDA defect. 42 analyses showed that the weight (p=0.043) and height (p=0.002) are highly associated with either VSD/PDA shunt size defect in general. It also showed that when VSD is taken alone, a shunt size defect of 0.4 cm predisposes to malnutrition (p=0.047), but not with PDA (p=0.268). Logistic regression showed that the risk of malnutrition increases as a function of VSD/PDA shunt size defect (risk estimate =1.54, 95% CI 1.19-2.00).
Conclusion. This study was able to establish the inverse relationships and the significant association between shunt size defect and the weight/height of patients with VSD or PDA. Logistic regression shows the probability of having malnutrition can be predicted from the VSD/PDA defect size.
Keywords. Malnutrition; shunt size defect; VSD/PDA