Association of BMI and pediatric urologic postoperative events: Results from pediatric NSQIP

BMI in the pediatric NSQIP urologic population was found to be associated with overall complication after adjustment for case type and preoperative comorbidity in a large national sample assembled for assessment of perioperative outcomes. An exploratory analysis uncovered more than two-fold increase in odds of wound complication in obese/overweight patients compared with a normal weight referent population. These results may be useful in preoperative counseling patients regarding perioperative risk.Table. Association of BMI with 30-day postoperative events in children after urologic procedures.BMI <85th percentileBMI ≥85th percentileFull cohortpaAny complicationb82 (4.1%)58 (6.7%)140 (4.9%)0.003 Urinary tract infection38 (1.9%)25 (2.9%)63 (2.2%)0.10 Postoperative bleeding26 (1.3%)15 (1.7%)41 (1.4%)0.35 Any wound complication21 (1.0%)23 (2.7%)44 (1.5%)0.002 Superficial surgical site infection9 (0.5%)13 (1.5%)22 (0.8%)0.005 Deep surgical site infection3 (0.2%)4 (0.5%)7 (0.2%)0.21c Organ space infection2 (0.1%)5 (0.6%)7 (0.2%)0.02c Dehiscence9 (0.5%)3 (0.4%)12 (0.4%)0.71Reoperation within 30 days27 (1.3%)17 (2.0%)44 (1.5%)0.21Readmission within 30 days78 (3.9%)46 (5.3%)124 (4.3%)0.08Any 30-day event150 (7.5%)92 (10.7%)242 (8.4%)0.004Odds of any 30-day event (unadjusted)-1.49 (1.13-1.95)-0.004Odds of any 30-day event (multivariable)-1.36 (1.03-1.82)-0.034Odds of wound complication (unadjusted)-2.60 (1.34-4.73)-0.002Odds of wound complication (multivariable)-2.36 (1.28-4.35)-0.006aObtained using logistic regression.bIn addition to complications shown, there were no cases of acute kidney injury, embolic events, or neurologic events.cObtained using two-tailed Fisher's exact test because of small cell count.