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Comparison of Clinical Outcomes and Medication Use of Obese Versus Nonobese Children Admitted to the Pediatric

Katy Stephens1, Philip Barker1, Erica Bergeron1

  • 1The University of Oklahoma College of Pharmacy, Oklahoma City, USA.

Hospital Pharmacy
|August 12, 2021
PubMed

Insights

Obesity in children admitted to the pediatric intensive care unit (PICU) did not impact mortality or length of stay. However, medication use, particularly continuous infusions, was associated with clinical outcomes in critically ill children.

Area of Science:

  • Pediatric Critical Care Medicine
  • Obesity Research
  • Clinical Outcomes Analysis

Background:

  • Limited research exists comparing clinical outcomes and medication use in obese versus nonobese children within the pediatric intensive care unit (PICU).
  • Understanding these differences is crucial for optimizing care for critically ill pediatric patients with obesity.

Purpose of the Study:

  • To compare clinical outcomes, including mortality, length of stay (LOS), and mechanical ventilation (MV) requirements, between obese and nonobese children in the PICU.
  • To analyze factors associated with these outcomes and differences in medication use between the two groups.

Main Methods:

  • A retrospective study analyzed 834 pediatric admissions (ages 2-17) over one year.
  • Patients were classified as obese (body mass index [BMI] ≥ 95th percentile) or nonobese (BMI < 95th percentile).
  • Binary regression models assessed the impact of obesity on clinical outcomes and medication use.

Main Results:

  • Obese children constituted 22.1% of admissions; no significant differences in mortality, MV requirement, or PICU LOS were observed between obese and nonobese groups.
  • While obesity itself was not linked to clinical outcomes, the number of medication classes and the use of continuous infusions showed an association.
  • Obese children had a higher incidence of receiving continuous infusions (24.4%) compared to nonobese children (8.8%).

Conclusions:

  • Obesity in children admitted to the PICU was not associated with increased mortality, prolonged LOS, or higher MV requirements.
  • The complexity of medication regimens, specifically the use of continuous infusions, was associated with clinical outcomes in critically ill children.
  • Further research into medication management strategies for obese pediatric patients in the PICU is warranted.

Keywords:
childmedicationsobesitypediatric intensive care unit

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