R. Duran1, R. Barry1, M. Modarresi1, E. Thimpson1, J. Sanabria1 1Marshall University Schoool Of Medicine,Department Of Surgery,Huntington, WV, USA
Introduction:
Obesity affects one in four adults in the West, and this epidemic has extended to the young patient. The aim of this study is to assess the effects of obesity in the pediatric population affected by blunt trauma at a Global, Country, State and local medical center level.
Methods:
The incidence, prevalence and mortality rates of blunt trauma by age, sex, cause, BMI, year, and geography were found using datasets from i) the Global Burden of Disease (GBD) group, where the epidemiological data obtained were modelled in DisMod-MR 2.1, a Bayesian meta-regression tool which pools data-points from different sources and adjusts for known sources of variability and iii) the local level II trauma registry at where data was modelled by JMP methods. GBD data was extracted from 284 country-year and 976 subnational-year combinations from 27 countries in North America, Latin America, Europe, and New Zealand from 1990 to 2015. Outpatient encounter data was also available from the USA, Norway, Sweden, and Canada for 48 country-years. There were 1026 pediatric patients admitted to the local trauma service who were evaluated (2014 to 2016).
Results:
The Global, USA and State (WV) mortality on pediatric patients from transport related injuries has decreased (from 55, 64 and 49% to 46, 58 and 41%, respectively) as well as from falls (from 43, 55 and 41% to 30, 52 and 25 %, respectively) from 1990 to 2015. The local cohort of pediatric patients included 880 non-obese (85.8%) and 146 obese (14.2%) patients. There was no significant difference in mortality rate, length of stay, ventilator support days, Glasgow Coma Scale score, presence of comorbidities or injury Severity score. The obese cohort, however, had a significantly longer ICU LOS. The average ICU LOS in our non-obese population was 2.46 vs 4.97 days in the obese group (p<0.05).
Conclusion: In the pediatric population, obesity is not a risk factor for fatality but for an increased ICU length of stay. Protocols engaging patients and parents aimed to pediatric weight control are being implemented.