Halvorson Elizabeth E, Saha Amit, Forrest Christopher B, Razzaghi Hanieh, Rao Suchitra, Phan Thao-Ly Tam, Magnusen Brianna, Mejias Asuncion, McCrory Michael C, Wells Brian J, Skelton Joseph A, Poehling Katherine A, Tieder Joel S
Departments of Pediatrics.
Anesthesiology.
Hosp Pediatr. 2021 Dec 1. doi: 10.1542/hpeds.2021-005975.
To identify associations between weight category and hospital admission for lower respiratory tract disease (LRTD), defined as asthma, community-acquired pneumonia, viral pneumonia, or bronchiolitis, among children evaluated in pediatric emergency departments (PEDs).
We performed a retrospective cohort study of children 2 to <18 years of age evaluated in the PED at 6 children's hospitals within the PEDSnet clinical research network from 2009 to 2019. BMI percentile of children was classified as underweight, healthy weight, overweight, and class 1, 2, or 3 obesity. Children with complex chronic conditions were excluded. Mixed-effects multivariable logistic regression was used to assess associations between BMI categories and hospitalization or 7- and 30-day PED revisits, adjusted for covariates (age, sex, race and ethnicity, and payer).
Among 107 446 children with 218 180 PED evaluations for LRTD, 4.5% had underweight, 56.4% had healthy normal weight, 16.1% had overweight, 14.6% had class 1 obesity, 5.5% had class 2 obesity, and 3.0% had class 3 obesity. Underweight was associated with increased risk of hospital admission compared with normal weight (odds ratio [OR] 1.76; 95% confidence interval [CI] 1.69-1.84). Overweight (OR 0.87; 95% CI 0.85-0.90), class 1 obesity (OR 0.88; 95% CI 0.85-0.91), and class 2 obesity (OR 0.91; 95% CI 0.87-0.96) had negative associations with hospital admission. Class 1 and class 2, but not class 3, obesity had small positive associations with 7- and 30-day PED revisits.
We found an inverse relationship between patient weight category and risk for hospital admission in children evaluated in the PED for LRTD.
在儿科急诊科（PED）接受评估的儿童中，确定体重类别与下呼吸道疾病（LRTD，定义为哮喘、社区获得性肺炎、病毒性肺炎或细支气管炎）住院之间的关联。
我们对2009年至2019年在PEDSnet临床研究网络内的6家儿童医院的PED接受评估的2至<18岁儿童进行了一项回顾性队列研究。儿童的BMI百分位数被分类为体重不足、健康体重、超重以及1、2或3级肥胖。患有复杂慢性病的儿童被排除。使用混合效应多变量逻辑回归来评估BMI类别与住院或7天和30天PED复诊之间的关联，并对协变量（年龄、性别、种族和民族以及付款人）进行调整。
在107446名因LRTD接受218180次PED评估的儿童中，4.5%体重不足，56.4%体重正常且健康，16.1%超重，14.6%为1级肥胖，5.5%为2级肥胖，3.0%为3级肥胖。与正常体重相比，体重不足与住院风险增加相关（比值比[OR]1.76；95%置信区间[CI]1.69 - 1.84）。超重（OR 0.87；95% CI 0.85 - 0.90）、1级肥胖（OR 0.88；95% CI 0.85 - 0.91）和2级肥胖（OR 0.91；95% CI 0.87 - 0.96）与住院呈负相关。1级和2级肥胖（而非3级肥胖）与7天和30天PED复诊有小的正相关。
我们发现在PED接受LRTD评估的儿童中，患者体重类别与住院风险之间存在反比关系。
