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The impact of obesity on 30-day complications in pediatric surgery

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Abstract

Purpose

To examine the effects of obesity on specialty-specific surgical outcomes in children.

Materials and methods

Retrospective cohort study using the National Surgical Quality Improvement Program, Pediatric, 2012–2014. Patients included those aged 2–17 years who underwent a surgical procedure in one of six specialties. Obesity was the primary patient variable of interest. Outcomes of interest were postoperative complications and operative times. Odds ratios for development of postoperative complications were calculated using stepwise multivariate regression analysis.

Results

Obesity was associated with a significantly greater risk of wound complications (OR 1.24, 95% CI 1.13–1.36), but decreased risk of non-wound complications (OR 0.68, 95% CI 0.63–0.73) and morbidity (OR 0.79, 95% CI 0.75–0.84). Obesity was not a significant factor in predicting postoperative complications in patients undergoing otolaryngology or plastic surgery procedures. Anesthesia times and operative times were significantly longer for obese patients undergoing most types of pediatric surgical procedures.

Conclusion

Obesity confers an increased risk of wound complications in some pediatric surgical specialties and is associated with overall decreased non-wound complications and morbidity. These findings suggest that the relationship between obesity and postoperative complications is complex and may be more dependent on underlying procedure- or specialty-related factors than previously suspected.

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Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, Women and Children’s Hospital of Buffalo, 219 Bryant Street, Buffalo, NY, 14222, USA

    A. T. Train, S. B. Cairo, H. A. Meyers, C. M. Harmon & D. H. Rothstein

  2. Department of Surgery, University at Buffalo, The State University of New York, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA

    C. M. Harmon & D. H. Rothstein

Authors
  1. A. T. Train
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  2. S. B. Cairo
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  3. H. A. Meyers
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  4. C. M. Harmon
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  5. D. H. Rothstein
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Contributions

Dr. ATT contributed to analysis and interpretation of data, drafting of the manuscript, and final approval. Dr. SBC contributed to analysis and interpretation of data, drafting of the manuscript, and final approval. Ms. HAM contributed to acquisition of data, critical revision of the manuscript, and final approval. Dr. CMH contributed to conception and design of the study, critical revision of the manuscript, and final approval. Dr. DHR contributed to conception and design of the study, analysis and interpretation of data, critical revision of the manuscript, and final approval.

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Correspondence to A. T. Train.

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Train, A.T., Cairo, S.B., Meyers, H.A. et al. The impact of obesity on 30-day complications in pediatric surgery. Pediatr Surg Int 33, 1167–1175 (2017). https://doi.org/10.1007/s00383-017-4131-2

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  • DOI: https://doi.org/10.1007/s00383-017-4131-2

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