Effect of body mass index percentile on pediatric gastrointestinal surgery outcomes

Background/purposePediatric obesity is an important public health concern, yet its effect on surgical outcomes is poorly understood. The purpose of this study was to determine if age and gender-specific body mass index (BMI) percentile influences complications and hospital resource utilization following pediatric gastrointestinal surgeries.MethodsPatients aged ≥ 2 to < 18 years who underwent appendectomy or other gastrointestinal operations were identified in the 2012–2013 Pediatric National Surgical Quality Improvement Program datasets. Age- and gender-specific pediatric BMI percentiles were calculated. Patients who underwent appendectomy (n = 9606) and those undergoing all other intestinal operations (n = 2664) were evaluated as separate cohorts.ResultsIn the appendectomy cohort, frequency of any complication increased with BMI category (normal weight 4.5%, overweight 5.3%, obese 5.7%, morbidly obese 7.3%, overall 5.0%, p = 0.014). In multivariate analysis, there was a quadratic association between BMI percentile and increased frequency of superficial incisional infection, unplanned tracheal intubation, and longer operative duration. In the intestinal surgery cohort, BMI percentile was not a predictor of any individual complication or any measure of hospital utilization.ConclusionsAge- and gender-specific BMI percentile was associated with increased risk of complications and longer operative duration in patients undergoing appendectomy but not other intestinal operations.