{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:38:46Z","timestamp":1792449526858,"version":"4.5.0"},"reference-count":24,"publisher":"American Academy of Pediatrics (AAP)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>Obesity is associated with poor outcomes for specific clinical groups of hospitalized children, but few data exist on outcomes of children with obesity on a larger scale during hospitalization. Therefore, we aimed to determine if use outcomes differ between hospitalized children with obesity and hospitalized children without obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>We performed a retrospective longitudinal cohort study of all children aged 2 to 19 years hospitalized at a single academic institution between January 1, 2009, and December 31, 2016. BMI was calculated from documented height and weight; obesity was defined by using age- and sex-specific BMI percentile guidelines from the Centers for Disease Control and Prevention. Only All Patient Refined Diagnosis-Related Groups (APR-DRGs) with &amp;gt;100 admissions during the study period were included. Primary outcome measures included hospital length of stay, hospital cost, and 14-day readmission. Generalized linear and logistic models were used to determine adjusted differences for outcome measures between patients with and without obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Of 78\u2009756 included hospitalizations, obesity rates increased from 16.5% in 2009\u20132010 to 17.3% in 2015\u20132016 (P = .002). Only 6 (4.7%) of the 128 APR-DRGs examined were associated with increased use for patients with obesity: spinal procedures, tonsil and adenoid procedures, major respiratory procedures, peptic ulcer and gastritis, other musculoskeletal diagnoses, and other kidney and urinary tract diagnoses. There were no APR-DRGs with increased length of stay for children with obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Obesity is associated with increased hospitalization cost and readmission rates for a minority of diagnosis groups. Some groups of hospitalized children with obesity may benefit from targeted interventions to reduce obesity-specific risks. Future research should be focused on disparities in other relevant clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1542\/hpeds.2020-0136","type":"journal-article","created":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T14:20:10Z","timestamp":1604326810000},"page":"997-1001","source":"Crossref","is-referenced-by-count":1,"title":["Associations Between Obesity and Use for Pediatric Hospitalizations"],"prefix":"10.1542","volume":"10","author":[{"given":"Kathryn E.","family":"Kyler","sequence":"first","affiliation":[{"name":"Division of Hospital Medicine, Children\u2019s Mercy Kansas City, Kansas City, Missouri; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt","family":"Hall","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Children\u2019s Mercy Kansas City, Kansas City, Missouri; and"},{"name":"Children\u2019s Hospital Association, Lenexa, Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L.","family":"Bettenhausen","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Children\u2019s Mercy Kansas City, Kansas City, Missouri; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2020,11,1]]},"reference":[{"issue":"5","key":"2021120817554889800_B1","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1001\/jamapediatrics.2013.13","article-title":"Influence of obesity on clinical outcomes in hospitalized children: a systematic review","volume":"167","author":"Bechard","year":"2013","journal-title":"JAMA Pediatr"},{"issue":"6","key":"2021120817554889800_B2","doi-asserted-by":"crossref","first-page":"2167","DOI":"10.1542\/peds.2005-1832","article-title":"Orthopedic complications of overweight in children and adolescents","volume":"117","author":"Taylor","year":"2006","journal-title":"Pediatrics"},{"issue":"9","key":"2021120817554889800_B3","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1542\/hpeds.2017-0265","article-title":"Impact of obesity on asthma morbidity during a hospitalization","volume":"8","author":"Gross","year":"2018","journal-title":"Hosp Pediatr"},{"issue":"12","key":"2021120817554889800_B4","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1093\/infdis\/jix241","article-title":"Relationship between body mass index and outcomes among hospitalized patients with community-acquired pneumonia","volume":"215","author":"Bramley","year":"2017","journal-title":"J Infect Dis"},{"issue":"12","key":"2021120817554889800_B5","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1542\/hpeds.2017-0100","article-title":"Factors associated with documentation of obesity in the inpatient setting","volume":"7","author":"Katzow","year":"2017","journal-title":"Hosp Pediatr"},{"issue":"11","key":"2021120817554889800_B6","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1542\/hpeds.2019-0046","article-title":"Prevalence and trends in obesity among hospitalized children","volume":"9","author":"Kyler","year":"2019","journal-title":"Hosp Pediatr"},{"issue":"3","key":"2021120817554889800_B7","doi-asserted-by":"crossref","first-page":"e20173459","DOI":"10.1542\/peds.2017-3459","article-title":"Prevalence of obesity and severe obesity in US children, 1999\u20132016. 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