The impact of obesity on 30-day complications in pediatric surgery

Purpose: To examine the effects of obesity on specialty-specific surgical outcomes in children. Materials and methods: Retrospective cohort study using the National Surgical Quality Improvement Program, Pediatric, 2012–2014. Patients included those aged 2–17 years who underwent a surgical procedure in one of six specialties. Obesity was the primary patient variable of interest. Outcomes of interest were postoperative complications and operative times. Odds ratios for development of postoperative complications were calculated using stepwise multivariate regression analysis. Results: Obesity was associated with a significantly greater risk of wound complications (OR 1.24, 95% CI 1.13–1.36), but decreased risk of non-wound complications (OR 0.68, 95% CI 0.63–0.73) and morbidity (OR 0.79, 95% CI 0.75–0.84). Obesity was not a significant factor in predicting postoperative complications in patients undergoing otolaryngology or plastic surgery procedures. Anesthesia times and operative times were significantly longer for obese patients undergoing most types of pediatric surgical procedures. Conclusion: Obesity confers an increased risk of wound complications in some pediatric surgical specialties and is associated with overall decreased non-wound complications and morbidity. These findings suggest that the relationship between obesity and postoperative complications is complex and may be more dependent on underlying procedure- or specialty-related factors than previously suspected.