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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Childhood obesity: a risk factor for injuries observed at a level-1 trauma center
Ankur R Rana1, Marc P Michalsky, Steven Teich
1Division of Pediatric Surgery, Department of Surgery, The Ohio State University College of Medicine and Nationwide Children's Hospital, Columbus, OH 43205, USA.
Insights
Obese pediatric trauma patients face higher risks of extremity fractures and certain complications like deep vein thrombosis, despite similar overall outcomes to non-obese peers. This highlights obesity as a significant factor in pediatric injury management.
Area of Science:
- Pediatric Traumatology
- Obesity Research
- Clinical Outcomes
Background:
- Obesity is a known risk factor for morbidity in adult trauma patients.
- Understanding obesity's impact in pediatric trauma is crucial for effective management.
- Pediatric obesity rates continue to rise, necessitating research into associated health risks.
Purpose of the Study:
- To investigate the specific effects of obesity on pediatric trauma patients.
- To compare outcomes and injury patterns between obese and non-obese pediatric trauma cases.
- To identify potential risk factors and complications associated with obesity in this population.
Main Methods:
- Retrospective review of pediatric trauma patients (ages 6-20) from January 2004 to July 2007.
- Classification of patients into non-obese (BMI <95th percentile) and obese (BMI ≥95th percentile) groups.
- Comparison of demographic data, injury characteristics, treatment, and clinical outcomes between the two groups.
Main Results:
- Obese children (23%) had a higher incidence of extremity fractures and orthopedic surgery.
- Obese patients showed increased rates of decubitus ulcers and deep vein thrombosis (DVT).
- No significant differences were observed in mortality, length of stay, or Injury Severity Score.
Conclusions:
- Obesity in pediatric trauma patients is linked to a higher risk of extremity fractures requiring surgery.
- Obese pediatric trauma patients have an increased risk for complications such as DVT and decubitus ulcers.
- Findings in pediatric trauma align with observed effects of obesity in adult trauma populations.
Purpose:
Obesity is an independent risk factor in trauma-related morbidity in adults. The purpose of this study was to investigate the effect of obesity in the pediatric trauma population.
Methods:
All patients (6-20 years) between January 2004 and July 2007 were retrospectively reviewed and defined as non-obese (body mass index [BMI] <95th percentile for age) or obese (BMI > or =95th percentile for age). Groups were compared for differences in demographics, initial vital signs, mechanisms of injury, length of stay, intensive care unit stay, ventilator days, Injury Severity Score, operative procedures, and clinical outcomes.
Results:
Of 1314 patients analyzed, there were 1020 (77%) nonobese patients (mean BMI = 18.8 kg/m(2)) and 294 (23%) obese patients (mean BMI = 29.7 kg/m(2)). There was no significant difference in sex, heart rate, length of stay, intensive care unit days, ventilator days, Injury Severity Score, and mortality between the groups. The obese children were significantly younger than the nonobese children (10.9 +/- 3.3 vs 11.5 +/- 3.5 years; P = .008) and had a higher systolic blood pressure during initial evaluation (128 +/- 17 vs 124 +/- 16 mm Hg, P < .001). In addition, the obese group had a higher incidence of extremity fractures (55% vs 40%; P < .001) and orthopedic surgical intervention (42% vs 30%; P < .001) but a lower incidence of closed head injury (12% vs 18%; P = .013) and intraabdominal injuries (6% vs 11%; P = .023). Evaluation of complications showed a higher incidence of decubitus ulcers (P = .043) and deep vein thrombosis (P = .008) in the obese group.
Conclusion:
In pediatric trauma patients, obesity may be a risk factor for sustaining an extremity fracture requiring operative intervention and having a higher risk for certain complications (ie, deep venous thrombosis [DVT] and decubitus ulcers) despite having a lower incidence of intracranial and intraabdominal injuries. Results are similar to reports examining the effect(s) of obesity on the adult population.
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