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Characterizing the spectrum of body mass index associated with severe postoperative pulmonary complications in

Leanne Thalji1, Yu Shi2, Kristine T Hanson3

  • 1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. thalji.leanne@mayo.edu.

Journal of Anesthesia
|April 13, 2019
PubMed

Insights

Overweight children have a higher risk of severe pulmonary complications after surgery. This study found no increased risk for obese children, suggesting tailored perioperative care for overweight and obese pediatric patients.

Area of Science:

  • Pediatric surgery
  • Anesthesiology
  • Public health

Background:

  • High body mass index (BMI) is a known risk factor for pulmonary complications in adults.
  • The association between BMI and severe perioperative pulmonary complications (PPCs) in children is not well-established.

Purpose of the Study:

  • To evaluate the association between body mass index (BMI) and severe pediatric perioperative pulmonary complications (PPCs).

Main Methods:

  • Retrospective cohort study of 40,949 pediatric patients (aged 2-17 years) from the 2015 Pediatric National Surgical Quality Improvement Program (NSQIP-P).
  • Severe PPCs defined as pneumonia or reintubation within 3 or 7 days of surgery.
  • Logistic regression analyses adjusted for patient factors and surgical case-mix to assess BMI class (underweight, normal, overweight, obese) and severe PPCs.

Main Results:

  • Overweight BMI class was significantly associated with severe PPCs after adjustment (OR 1.84, p=0.03).
  • Neither underweight nor obese BMI classes were associated with severe PPCs after adjustment.
  • The overweight group comprised 15.0% of the study population.

Conclusions:

  • Overweight pediatric patients face an underappreciated elevated risk of severe PPCs.
  • Unlike some prior studies, this research did not find an increased risk in obese children, possibly due to bias or practice variations.
  • Both overweight and obese children may benefit from tailored perioperative care to optimize surgical outcomes.
Abstract

Keywords:
BMIPediatric surgeryRespiratory complications

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