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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Childhood body mass index and perioperative complications
Olubukola O Nafiu1, Paul I Reynolds, Olumuyiwa A Bamgbade
1Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA. onafiu@med.umich.edu
Insights
Overweight and obese children experienced more perioperative complications, including difficult airways and longer recovery times. However, unplanned hospital admissions did not differ significantly between weight groups.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Public Health
Background:
- Childhood overweight and obesity present significant public health challenges.
- Understanding perioperative risks associated with pediatric obesity is crucial for patient safety.
Purpose of the Study:
- To compare the incidence of quality assurance events in overweight/obese versus normal-weight children undergoing surgery.
- To identify specific perioperative morbidities associated with excess weight in pediatric surgical patients.
Main Methods:
- Retrospective review of a pediatric hospital's quality assurance database (2000-2004).
- Calculation of Body Mass Index (BMI) using measured height and weight for 6094 children.
- Comparison of quality assurance event frequencies between normal weight, overweight, and obese children based on NCHS/CDC growth charts.
Main Results:
- Overall prevalence of overweight and obesity was 31.6% in the study cohort.
- Overweight/obese children had higher rates of preoperative hypertension, type II diabetes, and bronchial asthma.
- Difficult airways, postanesthesia care unit (PACU) complications, and increased antiemetic use were more frequent in overweight/obese children.
Conclusions:
- Childhood overweight and obesity are highly prevalent in pediatric surgical patients.
- Excess weight is associated with increased perioperative morbidities.
- Further prospective research is needed to fully understand the impact of childhood obesity on anesthesia and surgical outcomes.
Background:
Our aim was to describe the incidence of quality assurance events between overweight/obese and normal weight children.
Methods:
This is a retrospective review of the quality assurance database of the Mott Children's Hospital, University of Michigan for the period January 2000 to December 2004. Using directly measured height and weight, we computed the body mass index (BMI) in 6094 children. Overweight and obesity were defined using age and gender-specific cut off according to the National Center for Health Statistics (NCHS)/Centers for Disease Control and Prevention (CDC) (2000) growth charts. Frequency of quality assurance events were compared between normal weight, overweight, and obese children.
Results:
There were 3359 males (55.1%) and 2735 females (44.9%). The mean age for the entire population was 11.9 +/- 5.2 while the mean BMI was 21.6 +/- 6.7 kg x m(-2). The overall prevalence of overweight and obesity was 31.6%. Obesity was more prevalent in boys than girls (P = 0.016). Preoperative diagnoses of hypertension, type II diabetes, and bronchial asthma were more common in overweight and obese than normal weight children (P = 0.0001 for hypertension, P = 0.001 for diabetes and P = 0.014 for bronchial asthma). Difficult airway, upper airway obstruction in the postanesthesia care unit (PACU) and PACU stay longer than 3 h and need for two or more antiemetics were more common in overweight and obese than normal weight children (P = 0.001). There was no significant difference in the incidence of unplanned hospital admission following an outpatient surgical procedure between normal weight and overweight/obese children.
Discussion:
Studies on perioperative aspects of childhood overweight and obesity are rare. Our report shows a high prevalence of overweight and obesity in this cohort of pediatric surgical patients. Certain perioperative morbidities are more common in overweight and obese than in normal weight children. There is a need for prospective studies of the impact of childhood overweight and obesity on anesthesia and surgical outcome.
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