Background

Childhood obesity has become a serious global healthcare challenge. No UK data currently define its anaesthetic and perioperative implications. We aimed to determine obesity prevalence amongst UK children undergoing general anaesthesia and the incidence of predefined adverse perioperative events, and to compare perioperative obesity rates with National Child Measurement Programme (NCMP) data.

Methods

During a site-selected consecutive 7-day study period, all children (2–16 yr) undergoing general anaesthesia were included. Anonymised hospital, surgical, and procedural details; demographic data; and adverse perioperative events were collected prospectively by Paediatric Anaesthesia Trainee Research Network (PATRN) collaborators.

Results

For this study, 102 UK hospitals participated and 4232 cases were included in the final analysis; 76% of hospitals did not routinely calculate BMI. In addition, 3030 (71.6%; 95% confidence interval [CI]: 70.2–73.0%) children of healthy weight were compared with 537 (12.7%; 11.7–13.7%) children who were overweight and 478 (11.3%; 10.3–12.2%) children with obesity. Children with obesity (n=71; 14.9%) more commonly underwent (adeno)tonsillectomy than children of healthy weight (n=282; 9.3%; P<0.001; odds ratio [OR] 2.15; 95% CI: 1.58–2.92). Fewer children with obesity (n=365; 77% vs n=2552; 85%) were anaesthetised by consultant anaesthetists (OR 0.62; 95% CI: 0.48–0.79). Mask ventilation was difficult for 3.7% of children with obesity vs 0.6% of children of healthy weight (difference 3.0%; 95% CI: 1.3–4.7%; P<0.001). Comparison with NCMP data demonstrated an over-representation of obesity amongst the paediatric surgical population.

Conclusions

This large multicentre cohort study suggests a concerning prevalence of children with obesity presenting for anaesthesia. These results should be used to inform optimal provision of care for this population and support perioperative healthcare initiatives to address the burden of childhood obesity.

Clinical trial registration

ClinicalTrials.gov Identifier: NCT03994419.

中文翻译：

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英国接受全身麻醉的儿童围手术期肥胖的患病率：一项前瞻性、多中心、观察性队列研究

背景

儿童肥胖已成为严重的全球医疗保健挑战。目前没有英国数据定义其麻醉和围手术期的影响。我们旨在确定接受全身麻醉的英国儿童的肥胖患病率和预定义的围手术期不良事件的发生率，并将围手术期肥胖率与国家儿童测量计划 (NCMP) 数据进行比较。

方法

在选定地点的连续 7 天研究期间，所有接受全身麻醉的儿童（2-16 岁）都包括在内。匿名的医院、手术和程序细节；人口统计数据; 和不良围手术期事件由儿科麻醉实习研究网络 (PATRN) 合作者前瞻性收集。

结果

本次研究共有 102 家英国医院参与，4232 例纳入最终分析；76% 的医院没有定期计算 BMI。此外，还比较了 3030 名（71.6%；95% 置信区间 [CI]：70.2-73.0%）体重健康的儿童与 537 名（12.7%；11.7-13.7%）超重儿童和 478 名（11.3%；10.3- 12.2%) 肥胖儿童。与健康体重儿童相比，肥胖儿童 ( n =71；14.9%) 更常接受扁桃体切除术 ( n =282；9.3%；P <0.001；优势比 [OR] 2.15；95% CI：1.58–2.92) . 肥胖儿童较少（n = 365；77% vs n=2552; 85%) 被顾问麻醉师麻醉 (OR 0.62; 95% CI: 0.48–0.79)。面罩通气很困难的肥胖儿童的3.7％VS健康体重的儿童的0.6％（差3.0％; 95％CI：1.3-4.7％; P <0.001）。与 NCMP 数据的比较表明，儿科手术人群中肥胖症的比例过高。

结论

这项大型多中心队列研究表明，需要麻醉的肥胖儿童的患病率令人担忧。这些结果应用于为该人群提供最佳护理提供信息，并支持围手术期医疗保健计划，以解决儿童肥胖的负担。

临床试验注册

ClinicalTrials.gov 标识符：NCT03994419。