Clinical Informatics Fellow Stanford University School of Medicine Palo Alto, California, United States
Background: Children with medical complexity (CMC) may be at risk for having overweight or obesity status due to preventable causes (overfeeding (given immobility and/or feeding tube dependence. As a result, overweight and obesity status are potential preventable comorbidities in this group of patients. No national study has previously documented the prevalence of overweight or obesity status among CMC and explored the impact of potential medical and social modifying factors. Objective: Our goal is to examine the association between overweight or obesity status and CMC, and evaluate the impact of social complexity on this association. Design/Methods: This is a retrospective cohort study of 1,210,849 children aged 2-18 with a completed encounter in 2022 using data from the PEDSnet learning health system network of 11 pediatric hospital institutions. CMC were defined as patients with > 1 serious chronic conditions in >1 organ system as defined by the pediatric complex chronic conditions (CCC) proposed by Feudtner et. al. schema. The primary outcome was overweight (85-95th percentile body mass index) or obesity status (> 95th percentile body mass index). Medical covariates investigated include presence of obesogenic conditions and medications associated with weight gain. Social covariates were investigated including the childhood opportunity index (COI). Analyses included descriptive statistics and multivariate logistic regression to examine association between CMC status and overweight/obesity status, adjusting for covariates.
