The impact of pediatric obesity on hospitalized children with lower respiratory tract infections in the United States

Yusuke Okubo, Kotaro Nochioka, Marcia A. Testa

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Objective: Obesity is the most common public health problem and is a clinically complicating risk factor among hospitalized children. The impact of pediatric obesity on the severity and morbidity of lower respiratory tract infections remains unclear. Materials and Methods: We conducted a retrospective cohort study of bronchitis and pneumonia among children aged 2-20 years using hospital discharge records. The data were obtained from the Kid's Inpatient Database in 2003, 2006, 2009, and 2012, and were weighted to estimate the number of hospitalizations in the United States. We used the International Classification of Diseases, Ninth Revision, Clinical Modification code (278.0×) to classify whether the patient was obese or not. We investigated the associations between pediatric obesity and use of mechanical ventilation using multivariable logistic regression model. In addition, we ascertained the relationships between pediatric obesity, comorbid blood stream infections, mean healthcare cost, and length of hospital stay. Results: We estimated a total of 133 602 hospitalizations with pneumonia and bronchitis among children aged between 2 and 20 years. Obesity was significantly associated with use of mechanical ventilation (adjusted OR 2.90, 95% CI 2.15-3.90), comorbid bacteremia or septicemia (adjusted OR 1.58, 95% CI 1.03-2.44), elevated healthcare costs (adjusted difference $383, 95%CI $276-$476), and prolonged length of hospital stay (difference 0.32 days, 95%CI 0.23-0.40 days), after adjusting for patient and hospital characteristics using multivariable logistic regression models. Conclusions: Pediatric obesity is an independent risk factor for severity and morbidity among pediatric patients with lower respiratory tract infections. These findings suggest the importance of obesity prevention for pediatric populations.

Original languageEnglish
Pages (from-to)1479-1484
Number of pages6
JournalClinical Respiratory Journal
Issue number4
Publication statusPublished - 2018 Apr
Externally publishedYes


  • bronchitis
  • kids inpatient database
  • obesity
  • pediatric
  • pneumonia

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine
  • Genetics(clinical)


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