Childhood obesity trends: Association with same-day hospital admission in a National Outpatient Surgical Population

Background: Although the prevalence of obesity in the general population and its perioperative implications among children undergoing inpatient surgeries are well known, little is known about obesity prevalence among children scheduled for am- bulatory surgery. Aims: Here, we report the trends of obesity and severe obesity among children who underwent ambulatory surgery across multiple centers in the United States and ex- plore the association of obesity status with admission following elective ambulatory surgery. Materials and Methods: Using data from the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (2012- 2019), we selected children 2- 18 years old who underwent outpatient surgical procedures under general anes- thesia and had documented height, weight, and body mass index (BMI) data. We es- timated the prevalence of overweight, obesity (class 1), and severe obesity (class 2 and class 3) patients and explored their association with same- day hospital admission, defined as hospital length of stay >= 1 day. Results: Data from 152 918 children (mean age: 9.7 +/- 4.7 years) were analyzed. Of these, 16.4% (n = 25 007) were overweight, 13.8% (n = 21 085) were class 1 obese, 5.2% (n = 7879) were class 2 obese, and 3.0% (n = 4623) were class 3 obese. From 2012 to 2019, class 2 or 3 obesity prevalence increased by 26.7% and 32.5%, respec- tively. Overweight and obese children had relatively higher odds of same- day hospital admission compared to healthy weight children (overweight odds ratio [95% confi- dence interval]: 1.05 [1.02, 1.08]; class 1 obesity: 1.04 [1.00, 1.07]; class 2 obesity: 1.09 [1.02, 1.16]; class 3 obesity: 1.20 [1.11, 1.30]). Discusion and Conclusion: The burden of obesity continues to increase in children scheduled for ambulatory surgery. Children with class 2 and class 3 obesity have higher rates of same- day hospital admission following elective ambulatory surgery compared to healthy weight children, a factor that should be considered in scheduling these patients.