TOP 72 - The Impact of Childhood Obesity on Severity of Illness in Community Acquired Pneumonia in the PICU.

Publication Number: 1831.TOP 72

Pooja Meili, University of Louisville School of Medicine, Louisville, KY, United States; Kelly A. Lyons, University of Louisville School of Medicine, Norton Children's Hospital, Louisville, KY, United States

Background: Obesity is a rising challenge, especially within the pediatric population. To date, pediatric obesity increases the risk for development of asthma, obstructive sleep apnea, diabetes mellitus, early aortic and coronary artery plaques, and is currently the most common secondary cause of pediatric hypertension. Furthermore, it has been shown that pediatric obese patients hospitalized with sepsis have longer hospitalizations and higher occurrence of organ dysfunction, specifically severe acute kidney injury and cardiopulmonary decompensation. Despite the noted studies demonstrating an association between childhood obesity and certain diagnoses, there is limited information to date on childhood obesity and its association with pulmonary infections, specifically community acquired pneumonia (CAP) within a critical care setting.

Objective: We aim to evaluate pediatric patients with CAP admitted to a single center pediatric intensive care unit (PICU), to determine associations between varying BMI and need for mechanical ventilation, duration of hospitalization, and increased rates of CAP complications such as parapneumonic effusions and pneumothorax. Our secondary aims focus on associations between demographic variables such as gender and ethnicity, and association with varying BMI patients as above.

Design/Methods: We conducted a single-center retrospective chart review between January 2010 – December 2024 including all pediatric patients between the ages of 2 to 18 years of age admitted to the PICU with a diagnosis of CAP. Patients were excluded if they had the following: history of a tracheostomy, did not meet age requirements,, not admitted to the PICU, history of congenital heart disease, on home respiratory support, were a resident of a long term care facility, and/or have a gastrostomy tube or gastrojejunostomy tube dependence. Demographic variables such as age, gender, BMI, and ethnicity were collected as well as clinical variables such as length of stay, imaging modalities obtained during admission, etiology of CAP, maximum respiratory support modality during course, and occurrence of parapneumonic effusion or pneumothorax. A total of 2532 patients were screened, with 249 patients meeting inclusion criteria. Statistical analysis to evaluate our study aims is actively occurring at the time of this submission. Analysis will be completed by January 2026.