title: Obesity in pediatric trauma.
abstract: OBJECTIVE
  The implications of childhood obesity on pediatric trauma outcomes are not clearly established. Anthropomorphic data were recently added to the National Trauma Data Bank (NTDB) Research Datasets, enabling a large, multicenter evaluation of the effect of obesity on pediatric trauma patients.
  
  
  METHODS
  Children ages 2 to 19years who required hospitalization for traumatic injury were identified in the 2013-2014 NTDB Research Datasets. Age and gender-specific body mass indices (BMI) were calculated. Outcomes included injury patterns, operative procedures, complications, and hospital utilization parameters.
  
  
  RESULTS
  Data from 149,817 pediatric patients were analyzed; higher BMI percentiles were associated with significantly more extremity injuries, and fewer injuries to the head, abdomen, thorax and spine (p values <0.001). On multivariable analysis, higher BMI percentiles were associated with significantly increased likelihood of death, deep venous thrombosis, pulmonary embolus and pneumonia; although there was no difference in risk of overall complications. Obese children also had significantly longer lengths of stay and more frequent ventilator requirement.
  
  
  CONCLUSIONS
  Among children admitted after trauma, increased BMI percentile is associated with increased risk of death and potentially preventable complications. These findings suggest that obese children may require different management than nonobese counterparts to prevent complications.
  
  
  METHODS
  Level III; prognosis study.
authors.affiliation: Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA; Department of Surgery, Harborview Medical Center and University of Washington, Seattle, WA. Electronic address: cwitt@u.washington.edu.
authors.forename: Cordelie E
authors.initials: CE
authors.lastname: Witt
authors.affiliation: Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA; Department of Surgery, Harborview Medical Center and University of Washington, Seattle, WA. Electronic address: sarbabi@u.washington.edu.
authors.forename: Saman
authors.initials: S
authors.lastname: Arbabi
authors.affiliation: Department of Surgery, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, ON, Canada. Electronic address: avery.nathens@sunnybrook.ca.
authors.forename: Avery B
authors.initials: AB
authors.lastname: Nathens
authors.affiliation: Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA; Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA. Electronic address: vavilala@u.washington.edu.
authors.forename: Monica S
authors.initials: MS
authors.lastname: Vavilala
authors.affiliation: Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA; Department of Pediatrics, University of Washington, Seattle, WA. Electronic address: fpr@u.washington.edu.
authors.forename: Frederick P
authors.initials: FP
authors.lastname: Rivara
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000150:complications* / Q000175:diagnosis; D011014:Pneumonia / Q000209:etiology; D011379:Prognosis; D011655:Pulmonary Embolism / Q000209:etiology; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D014481:United States; D020246:Venous Thrombosis / Q000209:etiology; D014947:Wounds and Injuries / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D055815:Young Adult
keywords: Body mass index; Complications; Obesity; Outcomes; Pediatric; Trauma