Retrospective cohort study finds persistent body mass index increases in pediatric patients following lower extremity surgery, highlighting the need for postoperative weight management.
Key Points
To quantify changes in body mass index (BMI) within 3 months following pediatric lower extremity surgery and determine whether patients with significant early weight gain return to baseline within 1 year.
Conducted a single-center retrospective review of 411 pediatric patients (<18 years of age) who underwent operative treatment for lower extremity fractures or elective surgery over a 3-year period.
Utilized multivariable logistic regression to evaluate associations between baseline clinical characteristics and a clinically meaningful increase in BMI z-score (≥0.20) at 3 months postoperatively.
A clinically meaningful increase in BMI z-score (≥0.20) occurred in 26.5% of patients (109/411) at 3 months, with an overall mean BMI increase of 0.33 kg/m² (95% CI: 0.08–0.59) and a mean BMI z-score change of -0.040 (95% CI: -0.093 to 0.013).
Among patients with significant early BMI gain who had 12- to 18-month follow-up data (N=49), only 28.6% (95% CI: 15.9–41.2%) returned to their preoperative baseline BMI.
Preexisting obesity-associated conditions versus fractures or other orthopaedic conditions was the only baseline factor significantly associated with an early BMI z-score increase (OR: 1.84, 95% CI: 1.04–3.25; P=0.037).