Division of Emergency Medicine, Children's National Medical Center, USA.
Accid Anal Prev. 2009 Sep;41(5):959-62. doi: 10.1016/j.aap.2009.05.011. Epub 2009 Jun 13.
Obesity is an epidemic in the United States. The relationship between traumatic injury and obesity in children is not well-studied. We hypothesized that overweight children suffer more severe injuries, different distributions of injuries and improper use of restraints in motor vehicle collisions.
We conducted a secondary analysis of the CIREN database of motor vehicle collisions of subjects 2-17 years old. Overweight was defined as a BMI percentile for age >85%. Significant injury was an Injury Severity Score (ISS) >15 or an Abbreviated Injury Scale (AIS) score greater than one. Further analysis looked at injuries classified as head, trunk, or extremities and appropriateness of restraints. Odds ratios compared the overweight to lean groups.
335 subjects met inclusion criteria with 35.5% of cases being overweight. For significant injury, overweight cases had an odds ratio of 1.2 [95% CI: 0.8-1.9]. Analysis by AIS for overall significant injury and to specific body regions also did not show any significant associations. Overweight versus lean subjects had an odds ratio of 1.3 [95% CI: 0.8-2.1] for improper use of restraints.
We found no significant relationship between pediatric injury severity, distribution of injuries, or restraint use and being overweight. Limitations of this study were the small sample size in this database and the large number of unrestrained subjects.
肥胖是美国的一个流行病。创伤与儿童肥胖之间的关系尚未得到充分研究。我们假设超重儿童会遭受更严重的伤害，受伤的分布不同，并且在机动车碰撞中使用约束装置不当。
我们对机动车碰撞的 CIREN 数据库进行了二次分析，研究对象为 2-17 岁的儿童。超重的定义为 BMI 年龄百分位数>85%。严重损伤是指损伤严重程度评分（ISS）>15 或简明损伤评分（AIS）>1。进一步的分析研究了头部、躯干或四肢受伤情况以及约束装置的使用情况。优势比（OR）比较了超重组与非超重组。
335 名符合纳入标准的患者中，有 35.5%的患者超重。对于严重损伤，超重病例的 OR 为 1.2（95%CI：0.8-1.9）。对总体严重损伤和特定身体部位的 AIS 分析也未显示出任何显著关联。超重与非超重儿童在约束装置使用不当方面的 OR 为 1.3（95%CI：0.8-2.1）。
我们没有发现儿童损伤严重程度、损伤分布或约束装置使用与超重之间存在显著关系。本研究的局限性是该数据库的样本量小，以及未使用约束装置的受试者数量多。
