Impact of Body Mass Index on Adverse Events in Children Undergoing Sedation for MRI

Area of Science:

• Pediatric Anesthesiology
• Medical Imaging Safety
• Public Health & Epidemiology

Background:

• Over 20% of US children have a nonhealthy body mass index (BMI).
• Sedation for magnetic resonance imaging (MRI) is common in children, including those with nonhealthy BMIs.
• Understanding risks associated with BMI during pediatric sedation is crucial for patient safety.

Purpose of the Study:

• To determine the association between body mass index (BMI) categories and the risk of adverse events (AEs) and airway interventions in children undergoing sedation for MRI.
• To quantify the increased odds of AEs and airway interventions in children with varying BMI classifications.

Main Methods:

• Retrospective cross-sectional study of 39,393 children undergoing sedation for MRI across 66 centers.
• Children's BMI values were categorized into underweight, healthy weight, overweight, obesity, and severe obesity.
• Multivariable logistic regression was used to analyze the risk of AEs and airway interventions in relation to BMI.

Main Results:

• Children categorized as overweight, obesity, and severe obesity showed significantly increased odds of major and moderate AEs.
• Specifically, adjusted odds ratios (aORs) for AEs ranged from 1.58 to 1.86 for these groups.
• Increased odds of major airway interventions were also observed in overweight (aOR 1.61), obese (aOR 1.83), and severely obese (aOR 1.9) children.

Conclusions:

• Children with overweight, obesity, and severe obesity undergoing sedation for MRI are at a significantly higher risk of adverse events and airway interventions.
• Underweight children also face an elevated risk of adverse events during MRI sedation.
• These findings highlight the importance of considering BMI in risk assessment for pediatric sedation during MRI procedures.