Home E-Weekly January 10, 2017

In Pediatric Patients, Obesity and SSIs Go Hand in Hand

Published: January 9, 2017

WEIGHTY MATTER Consider the relationship between obesity and SSIs when assessing pre-operative pediatric patients and their families.

Does obesity pose a significant health risk to surgical patients regardless of their age? It appears so. Although the correlation between obesity and surgical complications has been well documented in adults, a study published in the journal Surgical Infections suggests elevated body mass index in pediatric surgical patients increases the likelihood of developing surgical site infections.

In reviewing cases from more than 66,600 surgical patients ages 2 to 18, the authors of the study categorized each patient according to BMI: underweight, normal, overweight or obese. In the 1,380 patients who had SSIs — 767 male, 613 female — elevated BMI (overweight and obese) was shown to be a significant risk factor. Patients who had pediatric general surgery (3.6%) and cardiothoracic surgery (2.5%) reported the highest rates of SSIs. Also, the most common SSIs among overweight and obese patients were superficial incisional in nature.

The study's single-center review identified 115 patients with SSIs. Of these, nearly 30% were overweight or obese, with few other identifiable SSI risk factors. Here, appendectomy was the most common procedure associated with SSIs, and the subspecialties of pediatric surgery and pediatric orthopedics reported the highest rates of SSIs.

Healthcare providers should consider these potentially troubling statistics when assessing and counseling pre-operative pediatric patients and their families, the study's authors suggest.

Obesity has long been considered a risk factor for adults who are undergoing surgery. A 2011 study published in JAMA Surgery showed that obesity increases the risk of an SSI after colectomy by 60%. The study also illustrated how the presence of infection increased the cost of treatment by more than $17,300 per patient.

Bill Donahue

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