Literature DB >> 19635312

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

Ankur R Rana1, Marc P Michalsky, Steven Teich, Jonathon I Groner, Donna A Caniano, Dara P Schuster.   

Abstract

PURPOSE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSION: 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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Year:  2009        PMID: 19635312      PMCID: PMC3717372          DOI: 10.1016/j.jpedsurg.2008.11.060

Source DB:  PubMed          Journal:  J Pediatr Surg        ISSN: 0022-3468            Impact factor:   2.545


  20 in total

1.  Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents.

Authors:  Zuguo Mei; Laurence M Grummer-Strawn; Angelo Pietrobelli; Ailsa Goulding; Michael I Goran; William H Dietz
Journal:  Am J Clin Nutr       Date:  2002-06       Impact factor: 7.045

2.  Obesity and outcomes after blunt trauma.

Authors:  Therèse M Duane; Tracey Dechert; Michel B Aboutanos; Ajai K Malhotra; Rao R Ivatury
Journal:  J Trauma       Date:  2006-11

3.  The life course of severe obesity: does childhood overweight matter?

Authors:  Kenneth F Ferraro; Roland J Thorpe; Jody A Wilkinson
Journal:  J Gerontol B Psychol Sci Soc Sci       Date:  2003-03       Impact factor: 4.077

4.  Obesity is an independent risk factor of mortality in severely injured blunt trauma patients.

Authors:  Angela L Neville; Carlos V R Brown; Janie Weng; Demetrios Demetriades; George C Velmahos
Journal:  Arch Surg       Date:  2004-09

Review 5.  Effects of obesity on morbidity in children and adolescents.

Authors:  Aviva Must; Sarah E Anderson
Journal:  Nutr Clin Care       Date:  2003 Jan-Apr

6.  Body mass index and outcomes in critically injured blunt trauma patients: weighing the impact.

Authors:  Mark A Newell; Michael R Bard; Claudia E Goettler; Eric A Toschlog; Paul J Schenarts; Scott G Sagraves; Don Holbert; Walter J Pories; Michael F Rotondo
Journal:  J Am Coll Surg       Date:  2007-05       Impact factor: 6.113

7.  Body mass index of patients with elbow and ankle fractures requiring surgical treatment.

Authors:  O M Böstman
Journal:  J Trauma       Date:  1994-07

8.  The cushion effect.

Authors:  Saman Arbabi; Wendy L Wahl; Mark R Hemmila; Carla Kohoyda-Inglis; Paul A Taheri; Stewart C Wang
Journal:  J Trauma       Date:  2003-06

9.  Body-weight related to loss of reduction of fractures of the distal tibia and ankle.

Authors:  O M Böstman
Journal:  J Bone Joint Surg Br       Date:  1995-01

10.  Body habitus as a predictor of injury pattern after blunt trauma.

Authors:  B R Boulanger; D Milzman; K Mitchell; A Rodriguez
Journal:  J Trauma       Date:  1992-08
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  35 in total

1.  Do obese children experience more severe fractures than nonobese children? A cross-sectional study from a paediatric emergency department.

Authors:  Charisse Kwan; Quynh Doan; John Paul Oliveria; Melissa Ouyang; Andrew Howard; Kathy Boutis
Journal:  Paediatr Child Health       Date:  2014-05       Impact factor: 2.253

2.  Risk and injury severity of obese child passengers in motor vehicle crashes.

Authors:  Jong-Eun Kim; Min-Heng Hsieh; Phillip C Shum; R Shane Tubbs; David B Allison
Journal:  Obesity (Silver Spring)       Date:  2015-02-03       Impact factor: 5.002

Review 3.  Bone metabolism in obesity and weight loss.

Authors:  Sue A Shapses; Deeptha Sukumar
Journal:  Annu Rev Nutr       Date:  2012-08-21       Impact factor: 11.848

4.  CORR Insights®: Hospital for special surgery pediatric functional activity brief scale predicts physical fitness testing performance.

Authors:  Timothy E Cooney
Journal:  Clin Orthop Relat Res       Date:  2014-03-26       Impact factor: 4.176

5.  [Fracture stabilization in polytraumatized children].

Authors:  P C Strohm; P P Schmittenbecher
Journal:  Unfallchirurg       Date:  2011-04       Impact factor: 1.000

6.  Childhood obesity is associated with increased risk of most lower extremity fractures.

Authors:  Jeff Kessler; Corinna Koebnick; Ning Smith; Annette Adams
Journal:  Clin Orthop Relat Res       Date:  2013-04       Impact factor: 4.176

7.  Weight gain during external fixation.

Authors:  Brad A Culotta; Shawn R Gilbert; Jeffrey R Sawyer; Alice Ruch; Thomas Sellers
Journal:  J Child Orthop       Date:  2012-11-30       Impact factor: 1.548

8.  Pediatric obesity and traumatic lower-extremity long-bone fracture outcomes.

Authors:  Ian C Backstrom; Paul A MacLennan; Jeffrey R Sawyer; Aaron T Creek; Loring W Rue; Shawn R Gilbert
Journal:  J Trauma Acute Care Surg       Date:  2012-10       Impact factor: 3.313

Review 9.  Influence of obesity on clinical outcomes in hospitalized children: a systematic review.

Authors:  Lori J Bechard; Pamela Rothpletz-Puglia; Riva Touger-Decker; Christopher Duggan; Nilesh M Mehta
Journal:  JAMA Pediatr       Date:  2013-05       Impact factor: 16.193

10.  Childhood obesity as a risk factor for lateral condyle fractures over supracondylar humerus fractures.

Authors:  Eric D Fornari; Mike Suszter; Joanna Roocroft; Tracey Bastrom; Eric W Edmonds; John Schlechter
Journal:  Clin Orthop Relat Res       Date:  2013-04       Impact factor: 4.176

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