Injury Patterns in Obese Versus Nonobese Children Presenting to a Pediatric Emergency Department

Background: Two of the most prevalent problems facing youth in the United States are injury and obesity. Obesity increases the risk of injury, prolongs recovery time, and increases morbidity among injured children.

Objective: The purpose of this study was to compare characteristics of injuries between obese and nonobese children who presented to a pediatric emergency department.

Methods: Electronic medical records for all patients aged 3 to 14 years who sustained a traumatic injury (International Classification of Diseases, Ninth Revision [ICD-9] codes 800-899) and were seen in our hospital emergency department from January 1, 2005, to March 31, 2008, were obtained. Data collected included age, chief complaint, discharge diagnosis, gender, race, disposition, and weight. Patients with a weight at >95th percentile for age were considered obese. chi(2) analysis was used in comparing the groups; odds ratios (ORs) were calculated.

Results: During the study period, 24 588 children had ICD-9 codes that met our inclusion criteria. Of these, 1239 had no weights recorded, leaving 23 349 patients in our study population. Of these children, the mean age was 8.2 years (SD: +/-3.6 years), 60.7% were white, and 61.7% were male. Obese children represented 16.5% of the study population (n = 3861). Overall, obese and nonobese children had the same percentage of upper extremity injuries. However, obese children were significantly more likely to have lower extremity injuries compared with upper extremity injuries than were nonobese children (OR: 1.71 [95% confidence interval: 1.56-1.87]; P < .001). In addition, obese children had significantly fewer head and face injuries than nonobese children (OR: 0.54 [95% confidence interval: 0.50- 0.58]; P < .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 nonobese children. Strategies for preventing lower extremity injuries among obese youth should be sought.