What Role Does Body Mass Index Play in Hospital Admission Rates From the Pediatric Emergency Department?

Wyrick, Sara; Hester, Casey N.; Sparkman, Amy; O’Neill, Kathleen; Dupuis, Greg; Anderson, Michael P.; Cordell, Jared; Bogie, Amanda

doi:10.1097/pec.0b013e3182a21a23

Cited by 21 publications

(17 citation statements)

References 5 publications

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“…18 Little is known about the prevalence of underweight percentage among burn patients specifically, nor the effects of this nutritional marker on patient outcomes in the developing world, with US studies giving mixed results. [19][20][21] Despite hypothesizing that underweight status may correlate with poor outcomes in our study, we found that underweight did not have a predictive relationship with mortality.…”

Section: Our Patients and Western Patientscontrasting

confidence: 77%

Predictors of Mortality Among Pediatric Burn Patients in East Africa

Chelidze

Lim

Peck

et al. 2016

Journal of Burn Care & Research

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Little is known about the outcomes of pediatric burn patients in resource-limited and rural locations of the developing world. In March 2013, our pediatric burn unit existing in this setting established an electronic registry of all patients. The authors analyzed the registry to determine overall mortality rates and predictors of mortality, including that of underweight status and body part burned. The secure electronic database of all admissions was reviewed for age, gender, weight, burn percentage (TBSA%), body part burned, cause/place of injury, length of stay, underweight status, surgery performed, reason for discharge, and mortality. Univariable and multivariable logistic regression was used to determine the variables associated with mortality. Kaplan-Meier curves were also analyzed. A total of 211 cases (59.7% male) admitted from March 2013 to June 2014 were reviewed. The median age, %TBSA, and length of stay were 2.0 years (1.3-3.3), 8.0% (5.0-13.4), and 8.5 days (4-14). The overall mortality rate was 15/211 (7.1%). Most injuries were unintentional (93.8%) scalds (85.3%) occurring in the home (98.1%). Two factors were significantly associated with mortality in the final multivariable model: %TBSA (odds ratio = 1.31 for 1% increase in %TBSA; 95% confidence interval = 1.17-1.46) and younger age (odds ratio = 0.20; 0.07-0.63). This study characterizes mortality among patients at a pediatric burn unit serving a rural population in the developing world. The majority of pediatric burns were unintentional scalds occurring in the home. %TBSA and lower age were the strongest predictors of mortality. Burn location and underweight status were not independent predictors of mortality. Overall mortality was 7.1%. These data are applicable to improving outcomes for patients in this burn unit and similar settings of its kind.

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Section: Our Patients and Western Patientscontrasting

confidence: 77%

Predictors of Mortality Among Pediatric Burn Patients in East Africa

Chelidze

Lim

Peck

et al. 2016

Journal of Burn Care & Research

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“…Six studies that included ±1000 patients recruited in different hospital settings, therefore better representing the “true” prevalence for the respective geographical locations have been reported. Wyrik et al [64] from the US reported a prevalence of malnutrition of 24.5% based on ≤5%ile BMI. However, as the population studied was from emergency departments of tertiary care facilities there is a likelihood of selection bias.…”

Section: Prevalence Of Acute Malnutritionmentioning

confidence: 99%

Prevalence of Malnutrition in Pediatric Hospitals in Developed and In-Transition Countries: The Impact of Hospital Practices

et al. 2019

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Presently, undernutrition still goes undetected in pediatric hospitals despite its association with poor clinical outcomes and increased annual hospital costs, thus affecting both the patient and the health care system. The reported prevalence of undernutrition in pediatric patients seeking care or hospitalized varies considerably, ranging from 2.5 to 51%. This disparity is mostly due to the diversity of the origin of populations studied, methods used to detect and assess nutritional status, as well as the lack of consensus for defining pediatric undernutrition. The prevalence among inpatients is likely to be higher than that observed for the community at large, since malnourished children are likely to have a pre-existent disease or to develop medical complications. Meanwhile, growing evidence indicates that the nutritional status of sick children deteriorates during the course of hospitalization. Moreover, the absence of systematic nutritional screening in this environment may lead to an underestimation of this condition. The present review aims to critically discuss studies documenting the prevalence of malnutrition in pediatric hospitals in developed and in-transition countries and identifying hospital practices that may jeopardize the nutritional status of hospitalized children.

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“… 44 56 In addition, one study reported that 14.5% of obese or overweight children were admitted, compared with 16.5% normal-weight children. 42 For overweight children, one study reported a significant decrease 56 while one reported a non-significant decrease 37 in admissions compared with normal-weight children.…”

Section: Resultsmentioning

confidence: 99%

Healthcare utilisation in overweight and obese children: a systematic review and meta-analysis

et al. 2020

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ObjectiveThis systematic review and meta-analysis aims to systematically analyse the association of overweight and obesity with health service utilisation during childhood.Data sourcesPubMed, MEDLINE, CINAHL, EMBASE and Web of Science.MethodsObservational studies published up to May 2020 that assessed the impact of overweight and obesity on healthcare utilisation in children and adolescents were included. Studies were eligible for inclusion if the included participants were ≤19 years of age. Findings from all included studies were summarised narratively. In addition, rate ratios (RRs) and 95% CIs were calculated in a meta-analysis on a subgroup of eligible studies.Outcome measuresIncluded studies reported association of weight status with healthcare utilisation measures of outpatient visits, emergency department (ED) visits, general practitioner visits, hospital admissions and hospital length of stay.ResultsThirty-three studies were included in the review. When synthesising the findings from all studies narratively, obesity and overweight were found to be positively associated with increased healthcare utilisation in children for all the outcome measures. Six studies reported sufficient data to meta-analyse association of weight with outpatient visits. Five studies were included in a separate meta-analysis for the outcome measure of ED visits. In comparison with normal-weight children, rates of ED (RR 1.34, 95% CI 1.07 to 1.68) and outpatient visits (RR 1.11, 95% CI 1.02 to 1.20) were significantly higher in obese children. The rates of ED and outpatient visits by overweight children were only slightly higher and non-significant compared with normal-weight children.ConclusionsObesity in children is associated with increased healthcare utilisation. Future research should assess the impact of ethnicity and obesity-associated health conditions on increased healthcare utilisation in children with overweight and obesity.PROSPERO registration numberCRD42018091752

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What Role Does Body Mass Index Play in Hospital Admission Rates From the Pediatric Emergency Department?

Cited by 21 publications

References 5 publications

Predictors of Mortality Among Pediatric Burn Patients in East Africa

Predictors of Mortality Among Pediatric Burn Patients in East Africa

Prevalence of Malnutrition in Pediatric Hospitals in Developed and In-Transition Countries: The Impact of Hospital Practices

Healthcare utilisation in overweight and obese children: a systematic review and meta-analysis

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