[2360.8] The Injured Obese Child: Let's Give Them Some Ankle Support

Wendy J. Pomerantz, Michael A. Gittelman, Nathan L. Timm. Division of Emergency Medicine, Cincinnati Children's Hospital, Cincinnati, OH.

BACKGROUND: Two of the most prevalent problems facing our youth are injury and obesity, both resulting in great morbidity and mortality to U.S. children. Childhood obesity puts children at greater risk for injuries, prolongs recovery time, and increases morbidity among injured children.
OBJECTIVE: The purpose of this study is to determine if different body parts are injured in obese children compared to non-obese children so that prevention strategies may be developed.
DESIGN/METHODS: The electronic medical records for all patients > 3 years old, who sustained a traumatic injury (ICD 9 codes 800-899) seen in our hospital emergency department (ED) from 1/1/05-3/31/08 were obtained. The annual ED volume is 96,000 visits; approximately 10% of patients present with a chief complaint of injury. Data collected included: 1) age, 2) chief complaint, 3) discharge diagnosis, 4) gender, 5) race, 6) disposition, and 7) weight. Patient's with a weight that was > 95% for their age compared to national averages were considered obese. Chi square analysis was used in comparing the groups; odds ratios were calculated.
RESULTS: During the study period, 24,588 children had ICD 9 codes that met our inclusion criteria. Of these, 1,239 did not have weights recorded leaving 23,349 patients in our study population. Of these children, the mean age was 8.2 (s.d. +3.6) years, 60.7% were Caucasian, and 61.7% were male. Obese children represented 16.5% of the study population (n=3,861). Overall, obese and non-obese children had the same percentage of upper extremity injuries. However, obese children were significantly more likely to have lower extremity injuries compared to upper extremity injuries than non-obese children, O.R. 1.71 (95% C.I. 1.56, 1.87), p<0.001. In addition, obese children had significantly fewer head and face injuries than non-obese children, O.R. 0.54 (95% C.I. 0.50, 0.58), p<0.001.
CONCLUSIONS: Obese children are significantly more likely to sustain lower extremity injuries than upper extremity injuries and less likely to sustain head and face injuries than non-obese children. Strategies to prevent injuries lower extremity injuries among obese youth should be sought.
E-PAS2009:2360.8

Date: Saturday, May 2, 2009
Platform Session: Injury Prevention: New Millenium Morbidities: Focusing Our Efforts on Injuries (10:15 AM - 12:15 PM)
Presentation Time: 12:00 PM
Room: 343-344 - Baltimore Convention Center
Course Number: 2360