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| |  Obesity Often Missed in Hospitalised Paediatric Patients: Presented at ENDO By Jill Stein SAN DIEGO -- June 21, 2010 -- Early data presented here at the 92nd Annual Meeting of the Endocrine Society (ENDO) suggest that obesity is frequently under-identified in paediatric inpatients. The findings, from a quality improvement analysis, were released on June 20 by Anshu Gupta, MD, Division of Pediatric Endocrinology and Metabolism, Virginia Commonwealth University, Richmond, Virginia. Dr. Gupta and colleagues examined the identification of childhood obesity and interventions made during inpatient admission. For their analysis, the investigators reviewed the charts of all children admitted to a general paediatric service of an urban tertiary paediatric centre over a recent 10-week period. "Today, over one-third of children and adolescents in the United States are overweight or obese," the authors wrote in their poster presentation. "In the last 30 years, the number of obese 2 to 5 year olds and 12 to 19 year olds has tripled. The number of 6 to 11 year olds has quadrupled." Children whose records were examined ranged in age from 2 to 18 years. In all cases, their height, weight, and blood pressure had been measured at the time of admission. Body mass index (BMI) was calculated and BMI percentiles were derived from current Centers for Disease Control and Prevention (CDC) graphs for males and females for age. Obesity was defined as a BMI >95th percentile for age, and overweight referred to a BMI between the 85th and 95th percentiles. Of 80 children included in the analysis, 30 (37.5%) were obese, 9 (11.25%) were overweight, and 7 (8.75%) were underweight. Fewer than half (42.5%) had a BMI in a healthy weight range. Obesity was recorded in the admission statement in only 8% of the obese children. Only 1 obese child had obesity cited on a problem list with a referral to an outpatient obesity clinic. None of the 30 children determined to be obese was referred to a nutritionist during hospitalisation, and none underwent cholesterol and diabetes screening despite the fact that such screening is recommended by the American Academy of Pediatrics. The investigators pointed out that the prevalence of childhood obesity in their inpatient unit was higher than National Health and Nutrition Examination Survey (NHANES) data reported in 2007-2008 and that reported for the Richmond, Virginia, area. The higher prevalence of obesity in their paediatric inpatients "may suggest higher rates of hospitalisation for obese children" or it may be a result of the fact that the children at their institution are from the inner city and tend to have a higher rate of obesity, they said. Based on their findings, the authors called for provider training for assessment and identification of obesity and comorbidities along with the implementation of innovative strategies to assist in the identification process. Also, it might be useful to provide nutritional screening and counselling during hospital admission when the patient's entire family's attention "might be easily captured." [Presentation title: Identification of Childhood Obesity in Inpatient Setting: A Missed Opportunity. Abstract P2-716]
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