Obesity has minimal impact on clinical outcomes in children with inflammatory bowel disease

Abstract

Purpose: Childhood obesity is an increasing problem in affluent societies throughout the world. We sought to identify the impact of obesity on the outcome of inflammatory bowel disease (IBD) and determine differences (if any) between ulcerative colitis (UC) and Crohn's disease (CD).

Methods: The 2009 Kids' Inpatient Database was explored for all children (≤ 20 years) admitted with IBD. ICD-9 codes were used to identify obesity and complications, including hemorrhage, perforation, and complex fistulas. Logistic regression analysis accounting for demographics, underlying disease, surgical procedures, and obesity was performed to identify factors associated with complication development. Data are expressed as odds ratios (OR) and a 95% confidence interval (CI). A P value of 0.05 was regarded as significant.

Results: From 12,465 admissions, 164 children were obese (1.3%), with no difference between CD and UC (1.3% vs. 1.4%; P=0.60). Girls had a two-fold increase in obesity (OR: 2.06, CI: 1.48-2.86; P<0.01). Obesity had no effect on elective/emergent admission rate (OR: 0.85, CI: 0.54-1.35; P=0.49), perforation (OR: 0.76, CI: 0.13-4.46; P=0.76), hemorrhage (OR: 0.64,CI: 0.34-1.21; P=0.17), complex fistula (OR: 1.19, CI: 0.45-3.17; P=0.72), or requirement for surgery (OR: 0.80, CI: 0.48-1.31; P=0.37). While the overall clinical morbidity rate was 10.7%, obesity was not associated with the development of overall complications (OR 1.20, CI: 0.75-1.93; P=0.45) or length of stay (6.36 vs. 6.10 days; P=0.61). Obesity increased the rate of central venous catheter (CVC) infections (OR: 10.98, CI: 2.50-48.20; P<0.01).

Conclusions: Obesity was more prevalent in girls with IBD. While obesity did not alter disease severity, rate of surgical intervention, or hospital length of stay, it was associated with higher CVC infections.

Keywords: Crohn’s disease; Inflammatory bowel disease; Obesity; Ulcerative colitis.