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Updated: May 2, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Obesity and outcomes following burns in the pediatric population
Evan Ross1, Agnes Burris1, Joseph T Murphy1
1Pediatric Surgery, Children's Medical Center Dallas, Dallas, TX USA; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA.
Insights
Obese children with burns require more intensive medical care, including longer mechanical ventilation and BICU stays, but do not have higher mortality rates. This suggests obesity increases morbidity in pediatric burn patients.
Area of Science:
- Pediatric burn care
- Obesity in children
- Medical outcomes research
Background:
- Obesity is linked to worse outcomes in adult burn patients.
- The impact of obesity on pediatric burn outcomes is not well understood.
Purpose of the Study:
- To investigate the association between obesity and outcomes in pediatric burn patients.
- To compare outcomes between obese and non-obese children with thermal injuries.
Main Methods:
- Retrospective analysis of thermal injury data from 536 pediatric patients (≤18 years).
- Obesity defined by WHO or CDC growth charts (≥95th percentile).
- Outcomes compared between obese (n=154) and non-obese (n=382) children.
Main Results:
- Obese and non-obese children had similar TBSA, full-thickness burn percentages, and mortality rates.
- Obese children required significantly more days of mechanical ventilation (4.89 vs. 2.67 days).
- In a subgroup without inhalation injury, obese children had longer ICU LOS (18.59 vs. 9.51 days) and mechanical ventilation days (11.65 vs. 3.92 days).
Conclusions:
- Obese pediatric burn patients require more intensive medical support, including respiratory intervention and BICU care.
- Unlike adult findings, obesity was not associated with increased mortality in this pediatric cohort.
- Obesity appears to be a risk factor for increased morbidity in pediatric burn patients.
Purpose:
While obesity is associated with increased mortality and decreased functional outcomes in adult burn patients, the ramifications of larger than average body size in the pediatric burn population are less well understood. The present study examines whether obesity was associated with poor outcomes following pediatric burn injuries.
Methods:
Thermal injury data for patients ≤ 18 years of age admitted to a Level III burn center over ten years (n=536) was analyzed. Obesity was defined as ≥ 95 th percentile of weight for height according to the WHO growth charts (<2 years of age) or BMI for age according to the CDC growth charts (2-18 years of age). Outcomes were compared between thermally injured obese (n=154) and non-obese (n=382) children. All data was collected in accordance with IRB regulations.
Results:
Obese and non-obese thermally-injured children did not differ in TBSA, percentage of full thickness burn, or overall mortality. However, these groups were significantly different with respect to age (obese=7.16 ± 0.46 years, non-obese=9.38 ± 0.32 years, p<0.001) and days requiring mechanical ventilation (obese=4.89 ± 1.3 days, non-obese=2.67 ± 0.49 days, p<0.05). For thermally injured children admitted to the BICU without inhalation injury (n=175); the obese (n=46) and non-obese (n=129) did not differ significantly with respect to age, TBSA, percentage of full thickness burn or other outcome measures. However, significant differences between these groups were noted for ICU LOS (obese=18.59 ± 5.18 days, non-obese=9.51 ± 1.82 days, p<0.05) and number of days requiring mechanical ventilation (obese=11.65 ± 3.91 days, non-obese=3.92 ± 0.85 days, p<0.05).
Conclusion:
These data show thermally-injured obese pediatric patients required longer and more intensive medical support in the form of BICU care and respiratory intervention. Counter to findings in adult populations, differences in mortality were not observed. Collectively, these findings suggest obesity as a risk factor for increased morbidity in the pediatric burn population.
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