Journal of pediatric surgery · 2016
Obesity in pediatric trauma.
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Witt Cordelie E, Arbabi Saman, Nathens Avery B, Vavilala Monica S, Rivara Frederick P
Аннотация
BACKGROUND/PURPOSE: The implications of childhood obesity on pediatric trauma outcomes are not clearly established. Anthropomorphic data were recently added to the National Trauma Data Bank (NTDB) Research Datasets, enabling a large, multicenter evaluation of the effect of obesity on pediatric trauma patients.
METHODS: Children ages 2 to 19years who required hospitalization for traumatic injury were identified in the 2013-2014 NTDB Research Datasets. Age and gender-specific body mass indices (BMI) were calculated. Outcomes included injury patterns, operative procedures, complications, and hospital utilization parameters.
RESULTS: Data from 149,817 pediatric patients were analyzed; higher BMI percentiles were associated with significantly more extremity injuries, and fewer injuries to the head, abdomen, thorax and spine (p values <0.001). On multivariable analysis, higher BMI percentiles were associated with significantly increased likelihood of death, deep venous thrombosis, pulmonary embolus and pneumonia; although there was no difference in risk of overall complications. Obese children also had significantly longer lengths of stay and more frequent ventilator requirement.
CONCLUSIONS: Among children admitted after trauma, increased BMI percentile is associated with increased risk of death and potentially preventable complications. These findings suggest that obese children may require different management than nonobese counterparts to prevent complications.
LEVEL OF EVIDENCE: Level III; prognosis study.
METHODS: Children ages 2 to 19years who required hospitalization for traumatic injury were identified in the 2013-2014 NTDB Research Datasets. Age and gender-specific body mass indices (BMI) were calculated. Outcomes included injury patterns, operative procedures, complications, and hospital utilization parameters.
RESULTS: Data from 149,817 pediatric patients were analyzed; higher BMI percentiles were associated with significantly more extremity injuries, and fewer injuries to the head, abdomen, thorax and spine (p values <0.001). On multivariable analysis, higher BMI percentiles were associated with significantly increased likelihood of death, deep venous thrombosis, pulmonary embolus and pneumonia; although there was no difference in risk of overall complications. Obese children also had significantly longer lengths of stay and more frequent ventilator requirement.
CONCLUSIONS: Among children admitted after trauma, increased BMI percentile is associated with increased risk of death and potentially preventable complications. These findings suggest that obese children may require different management than nonobese counterparts to prevent complications.
LEVEL OF EVIDENCE: Level III; prognosis study.
Предметные рубрики MeSH
AdolescentBody Mass IndexChildChild, PreschoolDatabases, FactualFemaleHospitalizationHumansMalePediatric ObesityPneumoniaPrognosisPulmonary EmbolismRespiration, ArtificialRetrospective StudiesRisk FactorsSurgical Procedures, OperativeTrauma Severity IndicesUnited StatesVenous ThrombosisWounds and InjuriesYoung Adult