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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Is obesity a protective factor in pediatric trauma? A retrospective review in a tertiary trauma centre over the
Phoenix W Y Wong1, Kenneth K Y Wong2
1Division of Paediatric Surgery, Department of Surgery, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Insights
Childhood obesity may increase the risk of severe injuries in pediatric trauma patients, unlike the obesity paradox seen in adults. Further evaluation of obese children with trauma is essential to prevent overlooked injuries.
Area of Science:
- Pediatric Trauma Care
- Obesity Research
- Injury Epidemiology
Background:
- The obesity paradox, where obesity is linked to better outcomes in adult trauma patients, is not consistently observed in children.
- Conflicting results in pediatric populations necessitate further investigation into the role of childhood obesity in trauma outcomes.
Purpose of the Study:
- To investigate the impact of childhood obesity on outcomes following traumatic injury in pediatric patients.
- To compare injury severity, morbidity, mortality, and length of stay between obese and non-obese children sustaining trauma.
Main Methods:
- A retrospective analysis of children under 18 years old treated for impact trauma at a tertiary trauma center between 2010 and 2022.
- Obesity defined as body weight >95th percentile for age; outcomes compared using injury severity scores (ISS), morbidity/mortality, and length of stay (LOS).
- Subgroup analyses conducted based on injury causes and age groups, with severe injury defined as ISS > 15.
Main Results:
- 148 children were analyzed (23 obese, 123 non-obese), with similar injury causes and overall outcomes.
- The obese group experienced a longer length of stay (4 days vs. 2 days, p=0.022).
- A higher proportion of obese children under 11 years old sustained severe injuries (28.6% vs. 9%, p=0.034).
Conclusions:
- Childhood obesity does not appear to be protective in trauma and may be a risk factor for more severe injuries, particularly in younger children.
- Findings contrast with the adult obesity paradox, highlighting unique pediatric considerations.
- Careful assessment of obese children with trauma is crucial to ensure injuries are not underestimated or overlooked.
Purpose:
The obesity paradox has been demonstrated in the adult trauma population. Yet there are conflicting results in children. The study aims to investigate the effect of childhood obesity on the outcomes after sustaining trauma.
Method:
All children (< 18-year-old) who attended a tertiary trauma centre from January 2010 to March 2022 due to impact trauma were included. The obese group was defined by a body weight > 95th percentile for age, and others were in the non-obese group. Outcomes, including injury-severity-scores (ISS), morbidity/mortality and length-of-stay (LOS), were compared between the groups. Subgroup analyses were performed on causes of injury and age groups. Severe injury was defined by ISS > 15.
Results:
148 subjects were included in the analysis (23 in the obese group; 123 in the non-obese group). They were similar in terms of injury causes and outcomes. The obese group had longer LOS (4 days vs 2 days, p = 0.022), and a higher proportion of them had severe injuries when < 11-year-old (28.6% vs 9%, p = 0.034).
Conclusion:
In contrast to adults, childhood obesity appears not to be a protective factor in trauma, and may be a risk factor, especially in younger children, for more severe injuries. Careful evaluation of obese children sustaining trauma is warranted to prevent injuries from being overlooked.
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