Date of Award

January 2012

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Louise-Marie Dembry

Second Advisor

Karla Lawson

Abstract

Context

The prevalence of obesity among young Americans in the 6 to 19 year old category has tripled since the 1960's. Today, 50% of individuals in this age group are either overweight or obese (Kimm, 2002). Studies have shown that increased percentage of body fat weakens the body's immune system (Falagas, 2009). Moreover, trauma can be an immuno-compromising condition. A study by Brown et al. in 2006 showed that obese pediatric trauma patients had more sepsis (15% vs 4%, P = .007) and wound infection (26% vs. 8%, p = .03), along with other clinical complications.

Objective

This project serves as an extension of the Brown study in 2006. The goal was to focus on all infections and infection risk factors that occured during a pediatric trauma patient's hospitalization as it related with Body Mass Index percentile.

Design

A retrospective chart review of pediatric patients entered into the Trauma Registry at Dell Children's Medical Center of Central Texas (DCMC).

Main Outcome Measures:

Infection events using ICD-9 Coding System

Infection events using NHSN Surveillance definitions

Risk Factors for Infection:

Days on Mechanical Ventilation

Days with a Central Venous Catheter

Results

From the 1279 patients analyzed between June 1st, 2010 and March 31st, 2011, only 3 official hospital acquired infections were detected using NHSN surveillance criteria. On the other hand, 9 patients in this cohort received ICD-9 codes for infection. The rates of mechanical ventilation and central venous catheterization also yielded statistically insignificant results.

Conclusion

I cannot conclude that obesity is a risk factor for hospital Acquired Infections (HAIs) in pediatric trauma patients; nor can I conclude that obesity increases the risk for known HAI risk factors: prolonged hospitalization, mechanical ventilation and use of Central Venous Catheterization.

Comments

This is an Open Access Thesis.

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