Departments of Pediatrics.
Anesthesiology.
Hosp Pediatr. 2022 Aug 1;12(8):734-743. doi: 10.1542/hpeds.2021-006404.
To identify associations between weight status and clinical outcomes in children with lower respiratory tract infection (LRTI) or asthma requiring hospitalization.
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.
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]).
Both underweight and overweight or obesity are associated with increased severity of LRTI or asthma in hospitalized children.
确定体重状况与需要住院的下呼吸道感染（LRTI）或哮喘儿童的临床结局之间的关联。
我们对 2009 年至 2019 年期间，使用 PEDSnet 临床研究网络的电子健康记录数据，对因 LRTI 和/或哮喘住院的 2 至 17 岁儿童进行了回顾性队列研究。排除年龄<2 岁、有医疗复杂性的儿童和无法计算 BMI 的儿童。根据年龄和性别计算的 BMI 百分位，将儿童分为体重不足、正常体重、超重以及 1 型、2 型或 3 型肥胖。主要结局为需要正压呼吸支持和 ICU 入院。对以哮喘为主要诊断的儿童进行了亚组分析。采用包含年龄、性别和付款人作为固定效应的混合效应多变量逻辑回归模型对结局进行建模。
我们确定了 65132 例住院治疗；体重不足的占 6.7%，正常体重的占 57.8%，超重的占 14.6%，1 型肥胖的占 13.2%，2 型肥胖的占 5.0%，3 型肥胖的占 2.8%。超重和肥胖与正压呼吸支持（3 型肥胖与正常体重的比值比[OR] 1.62 [1.38-1.89]）和 ICU 入院（3 型肥胖与正常体重的 OR 1.26 [1.12-1.42]）相关，所有超重和肥胖类别均有显著相关性。体重不足也与正压呼吸支持（OR 1.39 [1.24-1.56]）和 ICU 入院（1.40 [1.30-1.52]）相关。
体重不足和超重或肥胖均与住院儿童的 LRTI 或哮喘严重程度增加相关。
