Cordelie E Witt1, Adam B Goldin2, Monica S Vavilala3, Frederick P Rivara4. 1. Department of Surgery, University of Washington, 1959 NE Pacific Street, Seattle, WA, USA, 98195; Harborview Injury Prevention and Research Center, 325 9th Ave, Box 359960, Seattle, WA, USA, 98104. Electronic address: cwitt@u.washington.edu. 2. Division of General and Thoracic Surgery, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, USA, 98105. Electronic address: adam.goldin@seattlechildrens.org. 3. Department of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA, USA, 98195; Harborview Injury Prevention and Research Center, 325 9th Ave, Box 359960, Seattle, WA, USA, 98104. Electronic address: vavilala@u.washington.edu. 4. Department of Pediatrics, University of Washington, 1959 NE Pacific Street, Box 356410, Seattle, WA, USA, 98195; Harborview Injury Prevention and Research Center, 325 9th Ave, Box 359960, Seattle, WA, USA, 98104. Electronic address: fpr@u.washington.edu.
Abstract
BACKGROUND/ PURPOSE: Pediatric obesity is an important public health concern, yet its effect on surgical outcomes is poorly understood. The purpose of this study was to determine if age and gender-specific body mass index (BMI) percentile influences complications and hospital resource utilization following pediatric gastrointestinal surgeries. METHODS: Patients aged ≥2 to <18years who underwent appendectomy or other gastrointestinal operations were identified in the 2012-2013 Pediatric National Surgical Quality Improvement Program datasets. Age- and gender-specific pediatric BMI percentiles were calculated. Patients who underwent appendectomy (n=9606) and those undergoing all other intestinal operations (n=2664) were evaluated as separate cohorts. RESULTS: In the appendectomy cohort, frequency of any complication increased with BMI category (normal weight 4.5%, overweight 5.3%, obese 5.7%, morbidly obese 7.3%, overall 5.0%, p=0.014). In multivariate analysis, there was a quadratic association between BMI percentile and increased frequency of superficial incisional infection, unplanned tracheal intubation, and longer operative duration. In the intestinal surgery cohort, BMI percentile was not a predictor of any individual complication or any measure of hospital utilization. CONCLUSIONS: Age- and gender-specific BMI percentile was associated with increased risk of complications and longer operative duration in patients undergoing appendectomy but not other intestinal operations.
BACKGROUND/ PURPOSE:Pediatric obesity is an important public health concern, yet its effect on surgical outcomes is poorly understood. The purpose of this study was to determine if age and gender-specific body mass index (BMI) percentile influences complications and hospital resource utilization following pediatric gastrointestinal surgeries. METHODS:Patients aged ≥2 to <18years who underwent appendectomy or other gastrointestinal operations were identified in the 2012-2013 Pediatric National Surgical Quality Improvement Program datasets. Age- and gender-specific pediatric BMI percentiles were calculated. Patients who underwent appendectomy (n=9606) and those undergoing all other intestinal operations (n=2664) were evaluated as separate cohorts. RESULTS: In the appendectomy cohort, frequency of any complication increased with BMI category (normal weight 4.5%, overweight 5.3%, obese 5.7%, morbidly obese 7.3%, overall 5.0%, p=0.014). In multivariate analysis, there was a quadratic association between BMI percentile and increased frequency of superficial incisional infection, unplanned tracheal intubation, and longer operative duration. In the intestinal surgery cohort, BMI percentile was not a predictor of any individual complication or any measure of hospital utilization. CONCLUSIONS: Age- and gender-specific BMI percentile was associated with increased risk of complications and longer operative duration in patients undergoing appendectomy but not other intestinal operations.
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