{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T18:21:01Z","timestamp":1784830861807,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T00:00:00Z","timestamp":1661299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Single\u2010ventricle patients require a series of surgeries, with the final stage being the Fontan. This form of circulation results in several long\u2010term complications, but the impact and consequences of nutrition status remain unclear. We sought to evaluate the incidence of malnutrition in Fontan patients and the impact on outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was a retrospective cohort study of children who underwent Fontan surgery between 1997 and 2018. Clinical, demographic, and nutrition data were collected, including weight, height, body mass index (BMI), and their respective <jats:italic>z<\/jats:italic> scores (<jats:italic>z<\/jats:italic> score for weight\u2010for\u2010age [WAZ], <jats:italic>z<\/jats:italic> score for height\u2010for\u2010age [HAZ], and <jats:italic>z<\/jats:italic> score for BMI\u2010for\u2010age [BMIZ]) pre\u2010Fontan, at discharge, 6 months, and 1, 5, and 10 years post\u2010Fontan. Malnutrition status was categorized using the American Society for Parenteral and Enteral Nutrition guidelines and the Michigan MTool. Fontan failure was defined as listing for heart transplant or death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 69 patients, moderate\u2010severe malnutrition occurred at any time point in 11% (<jats:italic>n<\/jats:italic>\u2009=\u20098) by WAZ, 16% (<jats:italic>n<\/jats:italic>\u2009=\u200911) by HAZ, and 6% (<jats:italic>n<\/jats:italic>\u2009=\u20094) by BMIZ. Moderate\u2010severe malnutrition persisted in 6.5%\u201312.9% at 10 years post\u2010Fontan. Compared with the pre\u2010Fontan period, there was no change in these parameters over time. There was no statistically significant difference in Fontan failure between degrees of pre\u2010Fontan malnutrition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is a 6%\u201316% incidence of moderate\u2010severe malnutrition in Fontan patients. Malnutrition is a condition that remains present in follow\u2010up. There was no association with anthropometric parameters and transplant\u2010free survival. A prospective multi\u2010institutional study is needed to understand the impact of malnutrition on long\u2010term outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpen.2437","type":"journal-article","created":{"date-parts":[[2022,8,6]],"date-time":"2022-08-06T09:24:07Z","timestamp":1659777847000},"page":"59-66","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Incidence and impact of malnutrition in patients with Fontan physiology"],"prefix":"10.1002","volume":"47","author":[{"given":"Ravneet","family":"Sekhon","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology, Stollery Children's Hospital University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rae R.","family":"Foshaug","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Stollery Children's Hospital University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul F.","family":"Kantor","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Keck School of Medicine of USC Children's Hospital Los Angeles Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gitanjali","family":"Mansukhani","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, LHSC Children's Hospital Western University London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew S.","family":"Mackie","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Stollery Children's Hospital University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth A.","family":"Hollander","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Lucile Packard Children's Hospital Stanford University Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kylie","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Stollery Children's Hospital University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4051-2185","authenticated-orcid":false,"given":"Jennifer","family":"Conway","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Stollery Children's Hospital University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.114.000079"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2016.09.048"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2016.12.036"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.2196\/16204"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607112440285"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13351"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.01.020"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","unstructured":"HorsleyM PathakS MoralesD LortsA MouzakiM.Nutritional outcomes of patients with pediatric and congenital heart disease requiring ventricular assist device.JPEN J Parenter Enteral Nutr. 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