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Incidence of perioperative adverse events in obese children undergoing elective general surgery
S El-Metainy1, T Ghoneim, E Aridae
1Department of Anaesthesia, Faculty of Medicine, High Institute of Public Health, University of Alexandria, Alexandria, Egypt. shelmetainy@yahoo.com
Insights
Obese children undergoing surgery face higher risks of breathing problems like desaturation and airway obstruction. These risks are more pronounced in younger obese children, highlighting the need for careful perioperative management.
Area of Science:
- Pediatric Anesthesiology
- Public Health
- Surgical Risk Assessment
Background:
- Global rise in childhood obesity presents unique challenges.
- Limited data on anesthetic and perioperative risks for obese children.
- Obesity impacts various physiological systems, potentially affecting surgical outcomes.
Purpose of the Study:
- To investigate the perioperative risks in overweight and obese children.
- To identify specific adverse events associated with childhood obesity.
- To quantify the increased risk of respiratory complications in this population.
Main Methods:
- Prospective study of 1465 children (aged 2-16) undergoing general surgery.
- Classification of children based on age- and sex-adjusted Body Mass Index (BMI).
- Collection of patient characteristics, comorbidities, and perioperative data.
Main Results:
- 10.5% obese and 15.2% overweight children identified.
- Obese children showed higher rates of arterial desaturation, difficult mask ventilation, airway obstruction, and bronchospasm.
- Increased relative risk (RR) of adverse respiratory events (adjusted-RR=1.49) and significant associations with asthma (adjusted-OR=1.8) and sleep apnea (adjusted-OR=4.03).
Conclusions:
- Childhood obesity is linked to a higher incidence of perioperative adverse respiratory events.
- Younger obese children experience a greater risk.
- Findings underscore the importance of considering obesity in pediatric surgical risk assessment and management.
Background:
A worldwide increase in the prevalence of obesity has been observed in both developed and developing countries. Few studies have addressed the anaesthetic or perioperative implications of childhood obesity.
Methods:
Children aged 2-16 yr undergoing general surgery were classified using age- and sex-adjusted BMI. Patient characteristic, co-morbidity, and perioperative data were collected to ascertain the risks associated with overweight and obese children.
Results:
We enrolled 1465 subjects in our study, of which 154 (10.5%) were classified as obese and a further 223 (15.2%) as overweight. After adjusting for age, we identified increased rates of arterial haemoglobin desaturation, difficult mask ventilation, airway obstruction, and bronchospasm in obese children. The relative risk (RR) of adverse respiratory events was higher among obese subjects than non-obese subjects and higher in younger age groups. Controlling for age, adjusted-RR (confidence interval) was 1.49 (1.2-1.86). There was a significant association between obesity and asthma with a higher odds ratio (OR) in younger age groups controlling for age: adjusted-OR=1.8 (1.15-2.82). A significant association was detected between obesity and sleep apnoea controlling for age: adjusted-OR=4.03 (2.37-6.8).
Conclusions:
These results suggest an increased incidence of perioperative adverse respiratory events in obese children, especially at younger ages.
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