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Title: Anaesthesia-Related Costs Higher in Overweight Children: Presented at ASA
URL: http://www.pslgroup.com/dg/2161FE.htm
Doctor's Guide
October 23, 2007


By Arushi Sinha, PhD

SAN FRANCISO, CA -- October 23, 2007 -- Although children often undergo routine surgical procedures, such as adenotonsillectomy, there is a growing incidence of childhood obesity that influences the outcomes of these interventions. Not only do significantly overweight children suffer from higher complication rates after surgery, they may also incur additional anaesthesiology-related costs. This was the focus of a study presented at the Annual Meeting of the American Society of Anesthesiologists (ASA).

Olubukola Nafiu, MD, Assistant Professor, Department of Anaesthesiology, University of Michigan, Ann Arbor, Michigan, United States, and his colleagues examined the role of obesity in influencing surgical outcomes for paediatric patients undergoing adenotonsillectomy.

"Childhood obesity is a growing problem," explained Dr. Nafiu. He added, "Though it has been shown that the rate of hospital charges are higher for obese adults versus normal-weight adults, the data does not yet exist in children."

The research team conducted a retrospective study of 1,226 children (55% male) age <18 years who were undergoing adenotonsillectomy. The patients ranged in age from 5 years or less (49.2%), ages 6 to 12 years (39.5%), and more than 12 years (11.3%).

Based on height and weight data, the BMI for all of the patients was calculated and referenced against the National Center for Health Statistics (NCHS)/Centers for Disease Control and Prevention (CDC) growth charts. Those with BMI below the 85th percentile were categorised as normal weight; those with BMI between the 85th and 95th percentile as overweight; and those with BMI greater than the 95th percentile as obese.

Obesity outcomes were further assessed with respect to length of stay (LOS) in hospital, hospital charges per day, and total hospital-related charges.

Results showed that 10.2% of these children were either overweight or obese. Additionally, the overweight and obese children had a higher incidence of hypertension, diabetes, and bronchial asthma (P <.001). The majority of patients (76.6%) were discharged within 24 hours of the adenotonsillectomy.

However, obese and overweight children were more likely to be hospitalised (P <.001), and more likely to have longer length of hospital stay (P <.001), as well as to have higher hospital-related charges. With respect to anaesthesia, obese and overweight children had higher charges (P =.04), with similar trends in laboratory and pharmacy charges.

Based on these results, the authors concluded that overweight or obese children undergoing adenotonsillectomy experienced higher hospital charges, partly as a result of higher rates of hospital admission.

"Clearly, there is a need to address the problem of childhood obesity," concluded Dr. Nafiu.


[Presentation title: Does High Body Mass Index Influence Resource Utilization in Children Undergoing Adeno-Tonsillectomy? Abstract A1635]

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