title: Childhood obesity and in-hospital asthma resource utilization.
abstract: OBJECTIVE
  To examine the relationship between pediatric obesity and inpatient length of stay (LOS), resource utilization, readmission rates, and total billed charges for in-hospital status asthmaticus.
  
  
  METHODS
  We conducted a cross-sectional study of patients 5 to 17 years old hospitalized with status asthmaticus to 1 free-standing children's hospital system over 12 months. Only hospitalized patients initially treated in the hospital's emergency department were included to ensure all therapies/charges were examined. Patients with complex chronic conditions, pneumonia, or lacking recorded body mass index (BMI) were excluded. The primary exposure was BMI percentile for age. The primary outcome was LOS (in hours). Secondary outcomes were 90-day readmission rate, billed charges, and resource utilization: number of albuterol treatments, chest radiographs, intravenous fluids, intravenous or intramuscular steroids, and intensive care unit admission. Bivariate, adjusted Poisson and logistic regression model analyses were performed.
  
  
  RESULTS
  Five hundred eighteen patients met inclusion criteria. Most had a normal BMI (59.7%); 36.7% were overweight or obese. LOS, readmissions, and resource utilization outcomes were not associated with BMI category on bivariate analyses. After adjustment for demographic/clinical characteristics, LOS decreased by 2% for each decile increase in BMI percentile for age. BMI percentile for age was not associated with billed charges, readmissions, or other measures of resource utilization.
  
  
  CONCLUSIONS
  Although BMI decile for age is inversely associated with LOS for in-hospital pediatric status asthmaticus, the effect likely is not clinically meaningful.
authors.affiliation: Department of Pediatrics, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
authors.forename: Jessica
authors.initials: J
authors.lastname: Bettenhausen
authors.forename: Henry
authors.initials: H
authors.lastname: Puls
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Queen
authors.forename: Christina
authors.initials: C
authors.lastname: Peacock
authors.forename: Stephanie
authors.initials: S
authors.lastname: Burrus
authors.forename: Christopher
authors.initials: C
authors.lastname: Miller
authors.forename: Ashley
authors.initials: A
authors.lastname: Daly
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Colvin
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies