title: Pediatric obesity and safety in inpatient settings: a systematic literature review.
abstract: OBJECTIVE
  Pediatric obesity affects more than 16% of American children and is associated with worse outcomes in hospitalized patients. A systematic literature review was performed to identify studies of adverse care events affecting obese pediatric patients in the emergency room, operating room, or inpatient wards.
  
  
  METHODS
  We systematically searched Medline for articles published from 1970 to 2013 regarding obesity and patient safety events in pediatric acute care settings. We determined the study design, number of patients studied, definition and prevalence of obesity, the relevant acute care setting, the specific association with obesity addressed, and the results of each study.
  
  
  CONCLUSIONS
  Thirty-four studies documented both procedural complications and issues with general hospital care. Most were retrospective and focused on surgery or anesthesia. Obese patients may have increased risk for a variety of adverse events. Further study could improve institutional patient safety guidelines to enhance care for obese children.
authors.affiliation: Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA ehalvors@wakehealth.edu.
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Halvorson
authors.affiliation: Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA Brenner FIT Program, Brenner Children's Hospital, Winston-Salem, NC, USA.
authors.forename: Megan B
authors.initials: MB
authors.lastname: Irby
authors.affiliation: Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA Brenner FIT Program, Brenner Children's Hospital, Winston-Salem, NC, USA Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Skelton
mesh_terms: D015992:Body Mass Index; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D009873:Operating Rooms / Q000706:statistics & numerical data*; D061214:Patient Safety; D010362:Patients' Rooms / Q000706:statistics & numerical data*; D063766:Pediatric Obesity / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D062606:Tertiary Care Centers; D014481:United States / Q000453:epidemiology
keywords: inpatient; obesity; pediatric; safety; surgery