title: Screening for co-morbidity in 65,397 obese pediatric patients from Germany, Austria and Switzerland: adherence to guidelines improved from the year 2000 to 2010.
abstract: OBJECTIVE
  The aim of the study was to analyze the adherence to current guidelines for co-morbidity screening in overweight and obese pediatric patients participating in the Adipositas-Patienten-Verlaufsdokumentation (APV) initiative in three German-speaking countries.
  
  
  METHODS
  APV database: 181 centers from Germany, Austria and Switzerland, specialized in obesity care, contributed standardized, anonymous data of medical examinations from 65,397 patients performed between 2000 and 2010. Completeness of screening for hypertension, dyslipidemia, and impaired glucose metabolism was analyzed using adjusted means.
  
  
  RESULTS
  Mean age of the cohort was 12.5 ± 2.9 years and 46.5% were male. 17.3% were overweight (>90th-97th percentile), 45.1% obese (>97th-99.5th percentile), and 37.7% extremely obese (>99.5th percentile). In 2000, blood pressure was documented for 55.1% of patients, increasing to 88.7% in 2010. The rate of lipid diagnostics also improved from 45.0 to 67.7%, and screening for diabetes rose from 32.7 to 62.3% in the same time period. Blood pressure measurements were performed more often during inpatient care (88.5%) compared to outpatient programs (77.5%). Screening was more complete with increasing age and increasing degree of obesity. In boys screening rate was higher than in girls.
  
  
  CONCLUSIONS
  During the 11-year period, screening for co-morbidity improved significantly in overweight or obese children and adolescents. However, adherence to guidelines is still insufficient in some institutions. Quality control based on benchmarking may improve obesity care and outcome.
authors: Institute of Epidemiology and Medical Biometry, University Ulm, Ulm, Germany. marion.flechtner-mors@uni-ulm.de
authors: Marion
authors: M
authors: Flechtner-Mors
authors: Susanna
authors: S
authors: Wiegand
authors: Ines
authors: I
authors: Gellhaus
authors: Heidi
authors: H
authors: Siefken-Kaletka
authors: Kurt
authors: K
authors: Widhalm
authors: Thomas
authors: T
authors: Reinehr
authors: Hans-Peter
authors: HP
authors: Roost
authors: Georg
authors: G
authors: Leipold
authors: Ulrike
authors: U
authors: Hoffmeister
authors: Reinhard W
authors: RW
authors: Holl
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001317:Austria; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology; D002648:Child; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000209:etiology; D050171:Dyslipidemias / Q000150:complications / Q000175:diagnosis; D005260:Female; D005858:Germany; D019983:Guideline Adherence / Q000639:trends*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis; D008055:Lipids / Q000097:blood; D008297:Male; D008403:Mass Screening / Q000639:trends*; D009767:Obesity, Morbid / Q000150:complications / Q000175:diagnosis; D050177:Overweight / Q000150:complications / Q000175:diagnosis; D063766:Pediatric Obesity / Q000150:complications / Q000175:diagnosis*; D017410:Practice Guidelines as Topic; D012737:Sex Factors; D013557:Switzerland
chemical_list: D001786:Blood Glucose; D008055:Lipids
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