title: Childhood obesity increases duration of therapy during severe asthma exacerbations.
abstract: OBJECTIVE
  Childhood obesity contributes to a wide array of medical conditions, including asthma. There is also increasing evidence in adult patients admitted to the intensive care unit (ICU) that obesity contributes to increased morbidity and to a prolonged length of stay. We hypothesized that obesity is associated with the need for increased duration of therapy in children admitted to the ICU with status asthmaticus.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A tertiary pediatric ICU in a university-affiliated children's hospital.
  
  
  METHODS
  We retrospectively examined data from all children older than 2 yrs admitted to the ICU with status asthmaticus between April 1997 and June 2004. Children were classified as normal weight (<95% weight-for-age percentile) or obese (>95% weight-for-age).
  
  
  METHODS
  None.
  
  
  RESULTS
  Of the 209 children admitted to the ICU with asthma, 45 (22%) were obese. Compared with children of normal weight, the obese children were older (9.7 +/- 4.4 vs. 8.0 +/- 4.3 yrs, p = .02), more likely to be female (60% vs. 37%, p < .01), and more likely to have been admitted to the ICU previously (40% vs. 20%, p = .01). The obese children also had a statistically significant difference in race (more likely to be Hispanic) and in baseline asthma classification (more likely to have persistent asthma). Despite similar severity of illness at ICU admission, obese children had a significantly longer ICU length of stay (116 +/- 125 hrs vs. 69 +/- 57 hrs, p = .02) and hospital length of stay (9.8 +/- 7.0 vs. 6.5 +/- 3.4 days, p < .01). Obese children also received longer courses of supplemental oxygen, continuous albuterol, and intravenous steroids.
  
  
  CONCLUSIONS
  Childhood obesity significantly affects the health of children with asthma. Obese children with status asthmaticus recovered more slowly from an acute exacerbation, even after adjustment for baseline asthma severity and admission severity of illness.
authors.affiliation: Department of Pediatrics, Connecticut Children's Medical Center, Hartford, CT, USA.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Carroll
authors.forename: Anita
authors.initials: A
authors.lastname: Bhandari
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Zucker
authors.forename: Craig M
authors.initials: CM
authors.lastname: Schramm
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D008297:Male; D009765:Obesity / Q000150:complications*; D012189:Retrospective Studies; D013224:Status Asthmaticus / Q000150:complications* / Q000628:therapy*