Hina Walia1, Onur Balaban2, Megan Jacklen3, Dmitry Tumin2, Vidya Raman2,4, Joseph D Tobias2,4. 1. Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. hina.walia@nationwidechildrens.org. 2. Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. 3. School of Medicine, The Ohio State University, Columbus, OH, USA. 4. Department of Anesthesiology and Pain Medicine, The Ohio State University, Columbus, OH, USA.
Abstract
OBJECTIVE: Obesity is a risk factor for surgical complications in adults and children. Differences in postsurgical outcomes according to severity of obesity [moderate: 95-98th age-gender-specific body mass index (BMI) percentile versus severe: ≥99th percentile] in children remain unclear. This study compared post-anesthesia care unit (PACU) stay and hospital admission between severely obese children and moderately obese children undergoing surgery. METHODS: In a retrospective review over a 6-month period, obese children, 2-18 years of age undergoing surgery were identified. Multivariate mixed-effects regression was used to compare PACU length of stay (LOS) need for opioid analgesia, and hospital admission between moderately and severely obese patients. RESULTS: There were 1324 records selected for inclusion. PACU LOS did not significantly differ between moderately obese (50 ± 36 min) and severely obese patients (55 ± 38 min). There were no differences between moderately and severely obese patients in use of opioids in the PACU. Yet, severely obese patients were more likely to require inpatient admission than moderately obese patients. CONCLUSIONS: The duration of PACU stay still averaged less than 1 h in our cohort, suggesting that the majority of these patients can be cared for safely in the outpatient setting. Future studies should focus on identifying the co-morbid conditions that may prolong postoperative PACU stay or result in unplanned hospital admission in moderately and severely obese patients. Our preliminary data suggest that these factors may include a younger age and the complexity or duration of the surgical procedure.
OBJECTIVE:Obesity is a risk factor for surgical complications in adults and children. Differences in postsurgical outcomes according to severity of obesity [moderate: 95-98th age-gender-specific body mass index (BMI) percentile versus severe: ≥99th percentile] in children remain unclear. This study compared post-anesthesia care unit (PACU) stay and hospital admission between severely obesechildren and moderately obesechildren undergoing surgery. METHODS: In a retrospective review over a 6-month period, obesechildren, 2-18 years of age undergoing surgery were identified. Multivariate mixed-effects regression was used to compare PACU length of stay (LOS) need for opioid analgesia, and hospital admission between moderately and severely obesepatients. RESULTS: There were 1324 records selected for inclusion. PACU LOS did not significantly differ between moderately obese (50 ± 36 min) and severely obesepatients (55 ± 38 min). There were no differences between moderately and severely obesepatients in use of opioids in the PACU. Yet, severely obesepatients were more likely to require inpatient admission than moderately obesepatients. CONCLUSIONS: The duration of PACU stay still averaged less than 1 h in our cohort, suggesting that the majority of these patients can be cared for safely in the outpatient setting. Future studies should focus on identifying the co-morbid conditions that may prolong postoperative PACU stay or result in unplanned hospital admission in moderately and severely obesepatients. Our preliminary data suggest that these factors may include a younger age and the complexity or duration of the surgical procedure.
Authors: Cynthia L Ogden; Margaret D Carroll; Lester R Curtin; Margaret A McDowell; Carolyn J Tabak; Katherine M Flegal Journal: JAMA Date: 2006-04-05 Impact factor: 56.272
Authors: Allison A Hedley; Cynthia L Ogden; Clifford L Johnson; Margaret D Carroll; Lester R Curtin; Katherine M Flegal Journal: JAMA Date: 2004-06-16 Impact factor: 56.272
Authors: Vidya T Raman; Kris R Jatana; Charles A Elmaraghy; Joseph D Tobias Journal: Int J Pediatr Otorhinolaryngol Date: 2013-10-22 Impact factor: 1.675