Alattar Zana, Hoebee Shelby, Ron Eyal, Kang Paul, vanSonnenberg Eric
University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA.
J Intensive Care Med. 2022 Apr;37(4):472-479. doi: 10.1177/0885066621992738. Epub 2021 Mar 9.
A systematic review done to evaluate obesity as a risk factor for injuries and mortality in motor vehicle accidents (MVAs) in the pediatric population, as there has not been a systematic review done in over 10 years. This study aims to update the literature regarding obesity as a risk factor for injuries in MVAs in the pediatric population.
A systematic review was conducted according to the PRISMA guidelines with strict inclusion and exclusion criteria, resulting in the use of 3 total articles to analyze obesity as a risk factor for overall injury and mortality in the pediatric population.
Zaveri et al demonstrated a statistically significant, but weak, decrease in the odds of extremity injury in overweight patients ages 2 to 17 years old (odds ratio [OR] = 0.6, 95% confidence interval [CI] = 0.4-1.0, ≤ 0.05). On the other hand, Pollack et al and Haricharan et al found an increase in extremity injury in the obese population, in ages 9 to 15 years (OR = 2.54, 95% CI = 1.15-5.59, ≤ 0.05), and 10 to 17 years (Age 10-13: OR = 6.06, 95% CI = 2.23-16.44, ≤ 0.05, Age 14-17 OR = 1.44, 95% CI = 1.04-2.00, ≤ 0.05), respectively. Haricharan et al also found an increase in thoracic injuries in obese children, ages 2 to 13 and increased risk of head/face/neck injury in obese children ages 2 to 5 (OR = 3.67, 95% CI = 1.03-13.08, ≤ 0.05), but a decreased risk of head injury in obese children ages 14 to 17 (OR = 0.33, 95% CI = 0.18-0.60, ≤ 0.05).
There are sparse data that are conflicting, regarding the effect of obesity on extremity injuries in the pediatric population. Obesity is not protective against thoracic, head, or abdominal injuries. However, it was found to be a risk factor for trunk injuries in ages 2 to 13, as well as head/face/neck injuries for ages 2 to 5. Since the literature is so sparse, further research is warranted in these areas.
进行一项系统评价，以评估肥胖作为儿科人群机动车事故（MVA）中受伤和死亡的风险因素，因为已有超过10年未进行过系统评价。本研究旨在更新有关肥胖作为儿科人群MVA中受伤风险因素的文献。
根据PRISMA指南进行系统评价，采用严格的纳入和排除标准，共使用3篇文章来分析肥胖作为儿科人群总体受伤和死亡的风险因素。
扎韦里等人证明，2至17岁超重患者肢体受伤几率有统计学意义但较弱的降低（优势比[OR]=0.6，95%置信区间[CI]=0.4-1.0，P≤0.05）。另一方面，波拉克等人和哈里查兰等人发现，9至15岁肥胖人群（OR=2.54，95%CI=1.15-5.59，P≤0.05）以及10至17岁肥胖人群（10至13岁：OR=6.06，95%CI=2.23-16.44，P≤0.05，14至17岁OR=1.44，95%CI=1.04-2.00，P≤0.05）肢体受伤增加。哈里查兰等人还发现，2至13岁肥胖儿童胸部受伤增加，2至5岁肥胖儿童头部/面部/颈部受伤风险增加（OR=3.67，95%CI=1.03-13.08，P≤0.05），但14至17岁肥胖儿童头部受伤风险降低（OR=0.33，95%CI=0.18-0.60，P≤0.05）。
关于肥胖对儿科人群肢体受伤的影响，现有数据稀少且相互矛盾。肥胖对胸部、头部或腹部受伤并无保护作用。然而，研究发现肥胖是2至13岁躯干受伤以及2至5岁头部/面部/颈部受伤的风险因素。由于文献如此稀少，这些领域有必要进一步开展研究。
