title: Pilot study comparing post-anesthesia care unit length of stay in moderately and severely obese children.
abstract: OBJECTIVE
  Obesity is a risk factor for surgical complications in adults and children. Differences in postsurgical outcomes according to severity of obesity [moderate: 95-98th age-gender-specific body mass index (BMI) percentile versus severe: ≥99th percentile] in children remain unclear. This study compared post-anesthesia care unit (PACU) stay and hospital admission between severely obese children and moderately obese children undergoing surgery.
  
  
  METHODS
  In a retrospective review over a 6-month period, obese children, 2-18 years of age undergoing surgery were identified. Multivariate mixed-effects regression was used to compare PACU length of stay (LOS) need for opioid analgesia, and hospital admission between moderately and severely obese patients.
  
  
  RESULTS
  There were 1324 records selected for inclusion. PACU LOS did not significantly differ between moderately obese (50 ± 36 min) and severely obese patients (55 ± 38 min). There were no differences between moderately and severely obese patients in use of opioids in the PACU. Yet, severely obese patients were more likely to require inpatient admission than moderately obese patients.
  
  
  CONCLUSIONS
  The duration of PACU stay still averaged less than 1 h in our cohort, suggesting that the majority of these patients can be cared for safely in the outpatient setting. Future studies should focus on identifying the co-morbid conditions that may prolong postoperative PACU stay or result in unplanned hospital admission in moderately and severely obese patients. Our preliminary data suggest that these factors may include a younger age and the complexity or duration of the surgical procedure.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. hina.walia@nationwidechildrens.org.
authors.forename: Hina
authors.initials: H
authors.lastname: Walia
authors.affiliation: Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
authors.forename: Onur
authors.initials: O
authors.lastname: Balaban
authors.affiliation: School of Medicine, The Ohio State University, Columbus, OH, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Jacklen
authors.affiliation: Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Tumin
authors.affiliation: Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.|Department of Anesthesiology and Pain Medicine, The Ohio State University, Columbus, OH, USA.
authors.forename: Vidya
authors.initials: V
authors.lastname: Raman
authors.affiliation: Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.|Department of Anesthesiology and Pain Medicine, The Ohio State University, Columbus, OH, USA.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
mesh_terms: D000293:Adolescent; D000758:Anesthesia / Q000379:methods*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D010865:Pilot Projects; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Discharge time; Obesity; Perioperative complications; Safety