TY - JOUR
T1 - Associations Between Weight and Lower Respiratory Tract Disease Outcomes in Hospitalized Children
AU - Halvorson, Elizabeth E.
AU - Saha, Amit
AU - Forrest, Christopher B.
AU - Razzaghi, Hanieh
AU - Brittan, Mark
AU - Christakis, Dimitri A.
AU - Cole, F. Sessions
AU - Mejias, Asuncion
AU - Phan, Thao Ly Tam
AU - McCrory, Michael C.
AU - Wells, Brian J.
AU - Skelton, Joseph A.
AU - Poehling, Katherine A.
AU - Tieder, Joel S.
N1 - Publisher Copyright:
Copyright © 2022 by the American Academy of Pediatrics.
PY - 2022/8
Y1 - 2022/8
N2 - OBJECTIVE: To identify associations between weight status and clinical outcomes in children with lower respiratory tract infection (LRTI) or asthma requiring hospitalization. METHODS: We performed a retrospective cohort study of 2 to 17 year old children hospitalized for LRTI and/or asthma from 2009 to 2019 using electronic health record data from the PEDSnet clinical research network. Children <2 years, those with medical complexity, and those without a calculable BMI were excluded. Children were classified as having underweight, normal weight, overweight, or class 1, 2, or 3 obesity based on Body Mass Index percentile for age and sex. Primary outcomes were need for positive pressure respiratory support and ICU admission. Subgroup analyses were performed for children with a primary diagnosis of asthma. Outcomes were modeled with mixed-effects multivariable logistic regression incorporating age, sex, and payer as fixed effects. RESULTS: We identified 65 132 hospitalizations; 6.7% with underweight, 57.8% normal weight, 14.6% overweight, 13.2% class 1 obesity, 5.0% class 2 obesity, and 2.8% class 3 obesity. Overweight and obesity were associated with positive pressure respiratory support (class 3 obesity versus normal weight odds ratio [OR] 1.62 [1.38–1.89]) and ICU admission (class 3 obesity versus normal weight OR 1.26 [1.12–1.42]), with significant associations for all categories of overweight and obesity. Underweight was also associated with positive pressure respiratory support (OR 1.39 [1.24–1.56]) and ICU admission (1.40 [1.30–1.52]). CONCLUSIONS: Both underweight and overweight or obesity are associated with increased severity of LRTI or asthma in hospitalized children.
AB - OBJECTIVE: To identify associations between weight status and clinical outcomes in children with lower respiratory tract infection (LRTI) or asthma requiring hospitalization. METHODS: We performed a retrospective cohort study of 2 to 17 year old children hospitalized for LRTI and/or asthma from 2009 to 2019 using electronic health record data from the PEDSnet clinical research network. Children <2 years, those with medical complexity, and those without a calculable BMI were excluded. Children were classified as having underweight, normal weight, overweight, or class 1, 2, or 3 obesity based on Body Mass Index percentile for age and sex. Primary outcomes were need for positive pressure respiratory support and ICU admission. Subgroup analyses were performed for children with a primary diagnosis of asthma. Outcomes were modeled with mixed-effects multivariable logistic regression incorporating age, sex, and payer as fixed effects. RESULTS: We identified 65 132 hospitalizations; 6.7% with underweight, 57.8% normal weight, 14.6% overweight, 13.2% class 1 obesity, 5.0% class 2 obesity, and 2.8% class 3 obesity. Overweight and obesity were associated with positive pressure respiratory support (class 3 obesity versus normal weight odds ratio [OR] 1.62 [1.38–1.89]) and ICU admission (class 3 obesity versus normal weight OR 1.26 [1.12–1.42]), with significant associations for all categories of overweight and obesity. Underweight was also associated with positive pressure respiratory support (OR 1.39 [1.24–1.56]) and ICU admission (1.40 [1.30–1.52]). CONCLUSIONS: Both underweight and overweight or obesity are associated with increased severity of LRTI or asthma in hospitalized children.
UR - http://www.scopus.com/inward/record.url?scp=85150048041&partnerID=8YFLogxK
U2 - 10.1542/hpeds.2021-006404
DO - 10.1542/hpeds.2021-006404
M3 - Article
C2 - 35822402
AN - SCOPUS:85150048041
SN - 2154-1663
VL - 12
SP - 734
EP - 742
JO - Hospital Pediatrics
JF - Hospital Pediatrics
IS - 8
ER -