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Updated: Sep 6, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
An Assessment of the Relationship Between BMI and Children Undergoing Surgical Procedures: A Retrospective Study
Megan E Paul1, Jacqueline G Wallace1, Brian A Coakley2
1Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Insights
Children with obesity undergoing surgery had more tonsillectomy/adenoidectomy and vascular access procedures. Wound dehiscence was the only complication linked to obesity, suggesting elective surgeries need not be deferred for weight loss.
Area of Science:
- Pediatric Surgery
- Obesity Research
- Surgical Outcomes
Background:
- Obesity is a known risk factor for surgical complications in adults.
- Limited data exist on the impact of childhood obesity on surgical outcomes.
- Understanding these differences is crucial for pediatric surgical care.
Purpose of the Study:
- To determine if children with obesity experience different postoperative outcomes compared to their peers.
- To identify specific surgical procedures and complications associated with childhood obesity.
Main Methods:
- Retrospective chart review of 737 patients aged 2-18 years undergoing surgery in 2018.
- Patients stratified by Body Mass Index (BMI) percentile: healthy weight, excess weight, and obesity.
- Statistical analysis using chi-square and Kruskal-Wallis tests.
Main Results:
- Children with obesity underwent more tonsillectomy/adenoidectomy and vascular access procedures.
- Obesity was associated with a higher incidence of pre-existing liver disease.
- Wound dehiscence was the sole postoperative complication significantly more frequent in children with obesity.
Conclusions:
- Children with obesity require specific procedures more often but are not generally more prone to surgical complications.
- Elective pediatric surgeries should not be routinely postponed solely for preoperative weight loss.
- Further research may elucidate specific risk factors and management strategies for obese pediatric surgical patients.
Abstract:
While multiple studies have documented that obesity increases the risk of operative complications among adults, little data exist on how obesity impacts surgical outcomes among children. We aimed to determine if children with obesity have different postoperative outcomes than their peers. A retrospective chart review was conducted of 875 patients aged between 2 and 18 years who underwent surgery during 2018. Patients were stratified, based on BMI percentile for age, as having less than healthy weight (<5th percentile), healthy weight (5th-84th percentile), excess weight (85th-94th percentile), or obesity (≥95th percentile). Demographic information and data on medical comorbidities and postoperative complications were collected. All analyses were conducted using chi-square or Kruskal-Wallis testing. Eighty-two patients were excluded due to lack of BMI data and 56 were excluded as they had below healthy weight. Of the remaining 737 patients, 475 (64.4%) had healthy weight, 124 (16.8%) had excess weight, and 138 (18.70%) had obesity. Children with obesity had more tonsillectomy/adenoidectomy (p < 0.01) and vascular access (p = 0.04) procedures compared with peers. Additionally, patients with obesity were more likely to have a pre-existing history of liver disease (p < 0.01) and more frequently developed postoperative wound dehiscence (p < 0.01). No other complications occurred more frequently among children with obesity. Children with obesity required more tonsillectomy/adenoidectomy and vascular access procedures. Wound dehiscence was the only complication that was associated with obesity. This suggests that children with obesity are not inherently more prone to experience surgical complications and therefore elective procedures should likely not be deferred until preoperative weight loss is achieved.
