Article

Childhood obesity: a risk factor for injuries observed at a level-1 trauma center

Division of Pediatric Surgery, Department of Surgery, The Ohio State University College of Medicine and Nationwide Children's Hospital, Columbus, OH 43205, USA.
Journal of Pediatric Surgery (Impact Factor: 1.31). 08/2009; 44(8):1601-5. DOI: 10.1016/j.jpedsurg.2008.11.060
Source: PubMed

ABSTRACT Obesity is an independent risk factor in trauma-related morbidity in adults. The purpose of this study was to investigate the effect of obesity in the pediatric trauma population.
All patients (6-20 years) between January 2004 and July 2007 were retrospectively reviewed and defined as non-obese (body mass index [BMI] <95th percentile for age) or obese (BMI > or =95th percentile for age). Groups were compared for differences in demographics, initial vital signs, mechanisms of injury, length of stay, intensive care unit stay, ventilator days, Injury Severity Score, operative procedures, and clinical outcomes.
Of 1314 patients analyzed, there were 1020 (77%) nonobese patients (mean BMI = 18.8 kg/m(2)) and 294 (23%) obese patients (mean BMI = 29.7 kg/m(2)). There was no significant difference in sex, heart rate, length of stay, intensive care unit days, ventilator days, Injury Severity Score, and mortality between the groups. The obese children were significantly younger than the nonobese children (10.9 +/- 3.3 vs 11.5 +/- 3.5 years; P = .008) and had a higher systolic blood pressure during initial evaluation (128 +/- 17 vs 124 +/- 16 mm Hg, P < .001). In addition, the obese group had a higher incidence of extremity fractures (55% vs 40%; P < .001) and orthopedic surgical intervention (42% vs 30%; P < .001) but a lower incidence of closed head injury (12% vs 18%; P = .013) and intraabdominal injuries (6% vs 11%; P = .023). Evaluation of complications showed a higher incidence of decubitus ulcers (P = .043) and deep vein thrombosis (P = .008) in the obese group.
In pediatric trauma patients, obesity may be a risk factor for sustaining an extremity fracture requiring operative intervention and having a higher risk for certain complications (ie, deep venous thrombosis [DVT] and decubitus ulcers) despite having a lower incidence of intracranial and intraabdominal injuries. Results are similar to reports examining the effect(s) of obesity on the adult population.

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    • "This weight/bone mass imbalance also places high levels of stress on growing bones and joints that may result in joint damage and may contribute to osteoarthritis in later years. [77] The occurrence of more severe fractures and bone disorders lead to the increased requirement of complex surgeries and joint replacements, especially in the setting of pediatric trauma, thus amplifying the physical and financial load of the disease in this population. [78] "
    Childhood Obesity, 01/2012; , ISBN: 978-953-51-0374-5
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    • "As a result, being normal weight resulted in less severe injuries. This is similar to the findings of Pomerantz et al. (2010) and Rana et al. (2009), who reported that adolescents of normal weight were less likely to have more severe injuries compared with overweight adolescents. However, the findings are in contrast to Bazelmans et al. (2004), who found no association between obesity and severity of injury. "
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