The effect of obesity on adverse outcomes and metabolism in pediatric burn patients

R. Kraft, David Herndon, F. N. Williams, A. M. Al-Mousawi, Celeste Finnerty, M. G. Jeschke

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

HYPOTHESIS: Obesity influences metabolism and increases the incidence of clinical complications and worsens outcomes in pediatric burn patients. DESIGN: Retrospective, single-center study. SUBJECTS: In all, 592 severely burned pediatric patients who had burns covering more than 30% of the total body surface area and who were treated between 2001 and 2008 were enrolled in this study. Patients were divided into ≥85th percentile (n=277) and normal (n=315) weight groups based on body mass index (BMI) percentiles. RESULTS: Patients stratified below (normal) and ≥85th percentile had similar age, gender distribution and total burn size. No significant differences were detected in the incidence of sepsis (11% for obese vs 10% for normal), the incidence of multiple organ failure (MOF) (21% for obese and 16% for normal) or mortality (11% for obese vs 8% for normal). Compared with the normal group, the ≥85th percentile group had low levels of constitutive proteins (α2macroglobulin and Apolipoprotein A1) (P<0.05 for both) as well as high levels of triglycerides and the acute-phase protein, C-reactive protein (P<0.05 for both) up to 60 days after injury. Patients ≥85th percentile showed a significant higher loss of bone mineral density and lipolysis compared with normal individuals. Stepwise logistic regression analysis revealed that BMI had a positive predictive value towards the maximum DENVER2 score, an index of organ failure (P<0.001). CONCLUSIONS: BMI≥85th percentile altered the post-burn acute phase and catabolic response but did not increase the incidence of sepsis, MOF or mortality in pediatric burn patients. Our results suggest that impaired metabolism and an altered inflammatory response already exists in patients starting at the 85th percentile BMI.

Original languageEnglish (US)
Pages (from-to)485-490
Number of pages6
JournalInternational Journal of Obesity
Volume36
Issue number4
DOIs
StatePublished - Apr 2012

Fingerprint

Obesity
Pediatrics
Body Mass Index
Multiple Organ Failure
Incidence
Burns
Sepsis
Organ Dysfunction Scores
Acute-Phase Reaction
Mortality
Acute-Phase Proteins
Lipolysis
Body Surface Area
Apolipoprotein A-I
Age Distribution
Protein C
C-Reactive Protein
Bone Density
Triglycerides
Logistic Models

Keywords

  • burn injury
  • catabolism
  • childhood obesity
  • hyper metabolism
  • overweight
  • pediatrics

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Endocrinology, Diabetes and Metabolism

Cite this

The effect of obesity on adverse outcomes and metabolism in pediatric burn patients. / Kraft, R.; Herndon, David; Williams, F. N.; Al-Mousawi, A. M.; Finnerty, Celeste; Jeschke, M. G.

In: International Journal of Obesity, Vol. 36, No. 4, 04.2012, p. 485-490.

Research output: Contribution to journalArticle

Kraft, R. ; Herndon, David ; Williams, F. N. ; Al-Mousawi, A. M. ; Finnerty, Celeste ; Jeschke, M. G. / The effect of obesity on adverse outcomes and metabolism in pediatric burn patients. In: International Journal of Obesity. 2012 ; Vol. 36, No. 4. pp. 485-490.
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