title: Impact of Obesity on Clinical Outcomes in Urban Children Hospitalized for Status Asthmaticus.
abstract: OBJECTIVE
  The prevalence of both childhood asthma and obesity remain at historically high levels and disproportionately affect urban children. Asthma is a common and costly cause for pediatric hospitalization. Our objective was to determine the effect of obesity on outcomes among urban children hospitalized with status asthmaticus.
  
  
  METHODS
  A retrospective cohort study was performed by using billing system data and chart review to evaluate urban children admitted for asthma. Demographics, asthma severity, reported comorbidities, and outcomes were assessed. Obesity was defined by BMI percentile (lean<85%, overweight 85%-95%, obese≥95%). Outcomes were length of stay, hospitalization charges, ICU stay, repeat admissions, and subsequent emergency department (ED) visits. Bivariate analysis assessed for differences between overweight/obese and lean children. Multivariable regression assessed the relationship between overweight status and primary outcomes while controlling for other variables. Post hoc age-stratified analysis was also performed.
  
  
  RESULTS
  The study included 333 subjects; 38% were overweight/obese. Overweight/obese children admitted with asthma were more likely than lean children to have subsequent ED visits (odds ratio 1.6, 95% confidence interval 1.0-2.6). When stratified by age, overweight/obese preschool-age children (<5 years) were >2 times as likely to have repeat ED visits than lean preschool-age children (odds ratio 2.3, 95% confidence interval 1.0-5.6). There were no differences in the other outcomes between overweight/obese and lean individuals within the entire cohort or within other age groups.
authors.affiliation: Pediatric Hospital Medicine, Tufts Floating Hospital for Children, Boston, Massachusetts; earagona@tuftsmedicalcenter.org.
authors.forename: Elena
authors.initials: E
authors.lastname: Aragona
authors.affiliation: Pediatric Pulmonary Medicine, and.
authors.forename: Eussra
authors.initials: E
authors.lastname: El-Magbri
authors.affiliation: Pediatric Pulmonary Medicine, and.
authors.forename: Justin
authors.initials: J
authors.lastname: Wang
authors.affiliation: Pediatric Pulmonary Medicine, and.
authors.forename: Tessa
authors.initials: T
authors.lastname: Scheckelhoff
authors.affiliation: Pediatric Pulmonary Medicine, and.
authors.forename: Trevor
authors.initials: T
authors.lastname: Scheckelhoff
authors.affiliation: Pediatric Pulmonary Medicine, and.
authors.forename: Assata
authors.initials: A
authors.lastname: Hyacinthe
authors.affiliation: Pediatric Pulmonology, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Suja
authors.initials: S
authors.lastname: Nair
authors.affiliation: Pediatric Hospital Medicine, Tufts Floating Hospital for Children, Boston, Massachusetts;
authors.forename: Amina
authors.initials: A
authors.lastname: Khan
authors.affiliation: Pediatric Pulmonary Medicine, and.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Nino
authors.affiliation: Pediatric Pulmonary Medicine, and.
authors.forename: Dinesh K
authors.initials: DK
authors.lastname: Pillai
mesh_terms: D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D063868:Patient Outcome Assessment; D015995:Prevalence; D012189:Retrospective Studies; D013224:Status Asthmaticus / Q000453:epidemiology / Q000628:therapy; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data