Lack of data may put overweight children at surgical risk

Researchers in Southampton have said the lack of data on overweight children presenting for surgery in the UK may be putting them at greater risk of complications.

The National Child Measurement Programme says that approximately  500,000 children undergo anaesthesia and surgery in England alone every year. Over nine per cent of four to five year olds in England were obese in 2017-18, with a further 12.8 per cent overweight.

While obese adults are considered to be high-risk and are subject to national guidelines for surgical treatment, there is currently little understanding of anaesthetic implications on obese children. Overweight or obese children may suffer from undiagnosed conditions such as hypertension, type 2 diabetes and asthma which increase the risks of surgery.

While it is anticipated all hospitals routinely measure weight, some do not routinely measure height prior to a procedure under general anaesthesia – thus preventing BMI from being calculated so medical staff are not alerted to the obese or overweight status of a child.

All UK hospitals performing general anaesthesia for children aged two to 16 years have been invited to collect data on all of those weighing more than 12kg by the Paediatric Anaesthetic Trainee Research Network (PATRN).

Dr Mark Edwards, a consultant in anaesthesia and perioperative medicine at University Hospital Southampton, said: “The current incidence of childhood obesity and the burden of complications in children presenting to UK hospitals for surgery is largely unknown. Adults in this category are deemed to be high-risk during and after surgery with a higher incidence of airway complications.

“Yet while there are published national guidelines on the best-practice management of these adult patients in the surgical period, no guidance exists for children or, indeed, any idea of prevalence which puts them at risk of complications.”