Childhood obesity: a risk factor for injuries observed at a level-1 trauma center
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.
- SourceAvailable from: Ambar Banerjee
- "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.  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.  "
Chapter: Comorbidities of Childhood ObesityChildhood 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. "
ABSTRACT: Childhood obesity's relationship to injury severity has not been determined. This study examined the relationship between obesity and injury severity, differences in injury severity between weight groups, and injury predictors. The sample included 611 adolescent males treated for injury at a 10-day camping event in Virginia. Findings indicate a significant relationship between body mass index percentile and injury severity (r = .08, p = .04) and less injury severity in normal-weight adolescents, F(2, 608) = 5.27, p < .01. Predictors of injury severity were cause, place injury occurred and injury type, R(2) change = .07, F(5, 601) = 6.52, p < .01. Implications are that overweight/obese adolescents may have increased risk of serious injuries. Examining predictors may decrease incidence of injuries at future events.Journal of pediatric nursing 10/2011; 27(5):508-13. DOI:10.1016/j.pedn.2011.10.001 · 0.92 Impact Factor
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ABSTRACT: Polytraumata sind im Kindesalter selten. Schwere Einzelverletzungen, v.a. isolierte Schädel-Hirn-Traumata, sind am häufigsten. Der Unfalltod ist jedoch nach wie vor die häufigste Todesursache bei Kindern >1Jahr in industrialisierten Ländern. Die Letalität der Polytraumata im Kindesalter liegt bei ca. 19%. Für das Überleben sind die Extremitätenverletzungen beim polytraumatisierten Kind von eher untergeordneter Bedeutung, spielen jedoch eine wichtige Rolle für das Langzeitergebnis und die Lebensqualität. Die Versorgungsstrategie der Extremitätenverletzungen im Kindesalter im Rahmen der Polytraumaversorgung unterscheidet sich in der Indikationsstellung deutlich zu den Indikationen bei Monoverletzungen. Hierbei wird v.a. Gesichtspunkten wie Intensivpflege, Lagerung und schnellere Mobilisierung Rechung getragen und die Indikation zum operativen Vorgehen viel großzügiger gestellt. Polytrauma is a rare diagnosis in childhood. Even after high-energy accidents isolated injuries of the skull and brain or extremities are more common. Injury is still the most frequent cause of death in childhood in industrialized countries. The lethality of polytraumatized children is about 19%. Injuries of the extremities do not play such an important role for the survival of polytraumatized children but for the definitive outcome. The diagnostic algorithm for polytraumatized children is related to adults and includes spiral computed tomography in the emergency room. Plain radiographs are still the gold standard for the diagnostic workup of fractures. Generally therapeutic approaches in the treatment of fractures in children are often conservative. Because of the special situation in polytrauma with ICU care and the need for venous catheters, fast mobilization and positioning in bed, indications for operative treatment and definitive stabilization of fractures are required for polytraumatized children. SchlüsselwörterPolytrauma–Kind–Schockraummanagement–Frakturstabilisierung–Extremitätenverletzungen KeywordsPolytrauma–Child–Trauma room management–Fracture stabilization–Injuries of the extremitiesDer Unfallchirurg 04/2011; 114(4):323-332. DOI:10.1007/s00113-011-1967-0 · 0.61 Impact Factor