Impact of pediatric obesity on surgical outcomes of lower extremity fractures: a nationwide analysis (2010-2019).

BACKGROUND

The issue of pediatric obesity is becoming increasingly severe, and it has significant implications for a variety of health conditions, such as orthopedic injuries. Obesity has been shown to influence surgical outcomes across various pediatric procedures, and lower extremity long bone fractures (LELBF) are prevalent in adolescents. One of the goals of this research was to look into the effect of obesity on the perioperative findings of pediatric LELBF.

METHODS

In the Nationwide Inpatient Sample database, we examined the medical records of 15,896 individuals with LELBF who were less than 18 years old and had operative fixation of fractures from 2010 to 2019. Patients were divided into groups that were obese and non-obese individuals. Length of stay (LOS), total hospital charges, and unfavorable discharge rates were among the outcomes evaluated.

RESULTS

Childhood obesity was present in 3.0% of the patients who were included. Obese patients exhibited a substantially prolonged duration of stay (median 3.0 days vs. 2.0 days, p < 0.001) and higher total expenditures ($45,055 vs. $40,561, p = 0.002). The rate of unfavorable discharge (transfer to rehabilitation or skilled-nursing facilities) was considerably higher in the obese group (4.16% vs. 2.0%, p < 0.001). Obesity was independently associated with several adverse outcomes such as extended LOS (odds ratio [OR] 1.566, 95% confidence interval [CI]: 1.281–1.914; p < 0.001) and worse discharge outcomes (OR 2.130, 95% CI: 1.482–3.060; p < 0.001). Conversely, obese patients had reduced odds of mechanical ventilation (MV) (OR 0.302, 95% CI: 0.118–0.776; p = 0.013).

CONCLUSIONS

Obesity adversely affects perioperative outcomes in pediatric LELBF surgeries, including longer hospital stays, and increased rates of adverse discharge. These findings underscore the importance of implementing targeted interventions, such as early obesity screening and perioperative risk stratification protocols, to improve outcomes for this vulnerable population.