P529 Recognition of obesity in children attending a paediatric emergency department (The ROiC Study). (June 2019)

• Record Type: Journal Article
• Authors: Cloonan, Jeanne; Dwyer, Emer; Carlos, Eimear; Farombi, Ireti
• Is Part Of: Archives of disease in childhood. Volume 104:(2019)Supplement 3
• Page Start: A365
• Page End: A365
• Publication Date: 2019-06
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-epa.864
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Background: Childhood obesity is a global public health problem, linked to adult obesity and its associated co-morbidities. A study in a Paediatric Emergency Department in London in the BMJ in 2014 found a low recognition and referral rate for Paediatric Obesity. 1 However, no such studies have been performed to date in Ireland. Aims: To ascertain the incidence of obesity in patients attending our Paediatric Emergency Department. To establish recognition of obesity by paediatric medical staff. Methods: This was a Prospective Study. Nursing staff were asked to measure heights along with weights at triage of children between 2 and 16 years of age, over a one week period. Inclusion criteria were paediatric medical patients, aged 2–16 yrs. Surgical/trauma patients, those who's height had not been documented and those who did not wait to be seen were excluded. BMI centiles were calculated on all those meeting inclusion criteria. In those who plotted as overweight or obese, age, gender, presenting complaint, co-morbidities and nutritional history, if taken, were documented, along with whether the raised BMI was recognised/documented by medical staff and if they received a referral for further follow-up. Results: A search of the Emergency Department IPMS system found 222 patients aged 2–16 years attended the Paediatric Emergency Department during the week of the study. The ED charts of 149 patients who met criteria were reviewed. Heights were recorded in 61/149 (40%). BMI centiles were plotted for those patients and 20/61 (33%) were found to be overweight or obese. Of these patients, 10 were overweight (between 91 st and 98 th Centile) and 10 were obese (>98 th Centile). 1/20 patients (5%) was noted to be obese and was referred to a dietician. 12(60%) were male and 8(40%) were female. The most common presenting complaints were abdominal pain 4(20%) and chest pain 3 (15%). 5/20 (25%) had other documented co-morbidities. Conclusions: These results show a low recognition of paediatric obesity in the Emergency Department by paediatric medical staff. These results also show a high incidence of obesity in our population however as only 40% of patients had heights measured the true incidence is difficult to determine. These results support the need for further education of paediatric staff in the recognition of obesity and the development of guidelines and an appropriate referral pathway. Reference: Knight M, Booth C. Obesity management in a Paediatric Emergency Department. BMJ Qual Improv Rep. 2014;3(1):u203067.w1454.