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Updated: Mar 10, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Obesity in pediatric trauma
Cordelie E Witt1, Saman Arbabi1, Avery B Nathens2
1Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA; Department of Surgery, Harborview Medical Center and University of Washington, Seattle, WA.
Insights
Childhood obesity increases the risk of death and serious complications in pediatric trauma patients. Obese children require different management strategies to prevent adverse outcomes.
Area of Science:
- Pediatric trauma research
- Obesity and health outcomes
- Injury epidemiology
Background:
- The impact of childhood obesity on pediatric trauma outcomes remains unclear.
- Recent addition of anthropomorphic data to the National Trauma Data Bank (NTDB) enables large-scale evaluation.
Purpose of the Study:
- To evaluate the effect of obesity on pediatric trauma patients using the NTDB.
- To analyze injury patterns, complications, and hospital utilization in relation to body mass index (BMI).
Main Methods:
- Analysis of 149,817 pediatric trauma patients (ages 2-19) from 2013-2014 NTDB datasets.
- Calculation of age and gender-specific BMI percentiles.
- Multivariable analysis of outcomes including injury patterns, operative procedures, complications, and hospital utilization.
Main Results:
- Higher BMI percentiles correlated with more extremity injuries and fewer head, abdominal, thoracic, and spinal injuries.
- Increased BMI percentiles were linked to higher likelihood of death, deep venous thrombosis, pulmonary embolism, and pneumonia.
- Obese children experienced longer hospital stays and greater ventilator requirement, with no difference in overall complication risk.
Conclusions:
- Elevated BMI percentile in pediatric trauma patients is associated with increased mortality risk and potentially preventable complications.
- Obese pediatric trauma patients may necessitate distinct management approaches to mitigate risks.
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.
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