Open AccessThe impact of pediatric obesity on hospitalized children with lower respiratory tract infections in the United States
Author(s) -
Okubo Yusuke,
Nochioka Kotaro,
Testa Marcia A.
Publication year - 2018
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12694
Subject(s) - medicine , obesity , bronchitis , logistic regression , pneumonia , retrospective cohort study , pediatrics , mechanical ventilation , respiratory tract infections , bacteremia , diagnosis code , risk factor , emergency medicine , respiratory system , environmental health , population , microbiology and biotechnology , biology , antibiotics
Objective Obesity is the most common public health problem and is a clinically complicating risk factor among hospitalized children. The impact of pediatric obesity on the severity and morbidity of lower respiratory tract infections remains unclear. Materials and Methods We conducted a retrospective cohort study of bronchitis and pneumonia among children aged 2‐20 years using hospital discharge records. The data were obtained from the Kid's Inpatient Database in 2003, 2006, 2009, and 2012, and were weighted to estimate the number of hospitalizations in the United States. We used the International Classification of Diseases, Ninth Revision, Clinical Modification code (278.0×) to classify whether the patient was obese or not. We investigated the associations between pediatric obesity and use of mechanical ventilation using multivariable logistic regression model. In addition, we ascertained the relationships between pediatric obesity, comorbid blood stream infections, mean healthcare cost, and length of hospital stay. Results We estimated a total of 133 602 hospitalizations with pneumonia and bronchitis among children aged between 2 and 20 years. Obesity was significantly associated with use of mechanical ventilation (adjusted OR 2.90, 95% CI 2.15‐3.90), comorbid bacteremia or septicemia (adjusted OR 1.58, 95% CI 1.03‐2.44), elevated healthcare costs (adjusted difference $383, 95%CI $276‐$476), and prolonged length of hospital stay (difference 0.32 days, 95%CI 0.23‐0.40 days), after adjusting for patient and hospital characteristics using multivariable logistic regression models. Conclusions Pediatric obesity is an independent risk factor for severity and morbidity among pediatric patients with lower respiratory tract infections. These findings suggest the importance of obesity prevention for pediatric populations.