Premium
Impact of Obesity on Outcomes in Critically Ill Children
Author(s) -
Davis Esther T.,
Xie Li,
Levenbrown Yosef
Publication year - 2018
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607117725043
Subject(s) - overweight , medicine , body mass index , mechanical ventilation , odds ratio , obesity , intubation , retrospective cohort study , intensive care unit , confidence interval , risk factor , anesthesia
Purpose : To examine whether obesity confers a protective effect on critically ill pediatric patients, similar to what has been reported in critically ill adults. Methods : A retrospective cohort study including patients aged 2–18 years admitted to a 24‐bed pediatric intensive care unit from 2009 to 2014. Patients were divided into 1 of 3 weight categories: normal weight (body mass index [BMI], 5%–84.9%), overweight (BMI, 85%–94.9%), and obese (BMI ≥95%). Outcomes investigated included mortality, need for intubation, need for inotropic support, and duration of mechanical ventilation. Results : A total of 1817 patient encounters met inclusion criteria. There was no difference in Pediatric Index of Mortality 2 scores between groups. There was a significantly smaller percentage of overweight and obese patients requiring intubation ( P = .003) and inotropic support ( P = .031) compared with normal‐weight patients. Being overweight or obese was neither protective nor a risk factor for mortality with an adjusted odds ratio of 1.83 (confidence interval [CI], 0.82–3.85; P = .12) and 1.51 (CI, 0.70–3.12; P = .27) comparing the overweight and obese groups with the normal‐weight group, respectively. There was no difference in duration of mechanical ventilation between the normal‐weight and overweight and obese groups ( P = .893 and 0.484, respectively). Conclusions : In critically ill pediatric patients, being overweight or obese was associated with decreased need for intubation and inotropic support compared with normal‐weight patients. However, being overweight or obese is neither protective nor a risk factor for mortality or duration of mechanical ventilation.