title: Childhood obesity: a risk factor for injuries observed at a level-1 trauma center.
abstract: OBJECTIVE
  Obesity is an independent risk factor in trauma-related morbidity in adults. The purpose of this study was to investigate the effect of obesity in the pediatric trauma population.
  
  
  METHODS
  All patients (6-20 years) between January 2004 and July 2007 were retrospectively reviewed and defined as non-obese (body mass index [BMI] <95th percentile for age) or obese (BMI > or =95th percentile for age). Groups were compared for differences in demographics, initial vital signs, mechanisms of injury, length of stay, intensive care unit stay, ventilator days, Injury Severity Score, operative procedures, and clinical outcomes.
  
  
  RESULTS
  Of 1314 patients analyzed, there were 1020 (77%) nonobese patients (mean BMI = 18.8 kg/m(2)) and 294 (23%) obese patients (mean BMI = 29.7 kg/m(2)). There was no significant difference in sex, heart rate, length of stay, intensive care unit days, ventilator days, Injury Severity Score, and mortality between the groups. The obese children were significantly younger than the nonobese children (10.9 +/- 3.3 vs 11.5 +/- 3.5 years; P = .008) and had a higher systolic blood pressure during initial evaluation (128 +/- 17 vs 124 +/- 16 mm Hg, P < .001). In addition, the obese group had a higher incidence of extremity fractures (55% vs 40%; P < .001) and orthopedic surgical intervention (42% vs 30%; P < .001) but a lower incidence of closed head injury (12% vs 18%; P = .013) and intraabdominal injuries (6% vs 11%; P = .023). Evaluation of complications showed a higher incidence of decubitus ulcers (P = .043) and deep vein thrombosis (P = .008) in the obese group.
  
  
  CONCLUSIONS
  In pediatric trauma patients, obesity may be a risk factor for sustaining an extremity fracture requiring operative intervention and having a higher risk for certain complications (ie, deep venous thrombosis [DVT] and decubitus ulcers) despite having a lower incidence of intracranial and intraabdominal injuries. Results are similar to reports examining the effect(s) of obesity on the adult population.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, The Ohio State University College of Medicine and Nationwide Children's Hospital, Columbus, OH 43205, USA.
authors.forename: Ankur R
authors.initials: AR
authors.lastname: Rana
authors.forename: Marc P
authors.initials: MP
authors.lastname: Michalsky
authors.forename: Steven
authors.initials: S
authors.lastname: Teich
authors.forename: Jonathon I
authors.initials: JI
authors.lastname: Groner
authors.forename: Donna A
authors.initials: DA
authors.lastname: Caniano
authors.forename: Dara P
authors.initials: DP
authors.lastname: Schuster
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009765:Obesity / Q000150:complications*; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D014947:Wounds and Injuries / Q000150:complications*; D055815:Young Adult