Identifying the body mass index of children awaiting dental surgery under general anaesthetic: an audit.

Abstract

Children with overweight or obesity are at risk of experiencing perioperative complications during general anaesthesia (GA). At Guy's and St Thomas' NHS Foundation Trust in London, children who require dental surgery under GA are placed on a waiting list for the Dental Day Surgery Unit (DDSU) or the Evelina London Children's Hospital (ELCH), which has inpatient beds and a paediatric intensive care unit, depending on their body mass index (BMI) and centile thresholds. The waiting list for the ELCH is longer than for the DDSU. This article discusses the results of a retrospective audit which involved analysis of the BMI of 300 children (aged ≤16 years) on the waiting lists for both sites (DDSU n =250; ELCH n =50). The aims were to identify those who were overweight or very overweight, calculate how much weight loss would be required for some of those allocated to the ELCH to be treated instead at the DDSU and to achieve a healthy weight, and to compare obesity prevalence with national data. The results identified 57 (19%) of the 300 patients as very overweight or overweight. A total of 24 (48%) patients on the ELCH waiting list ( n =50) were identified as very overweight or overweight. For seven (29%) of these 24 patients, the amount of weight loss required to be treated at the DDSU ranged between 19.5kg and 0.9kg and the amount of weight loss required to attain a healthy weight ranged between 28.5kg and 11.5 kg. The prevalence of obesity among the audit cohort was lower than national obesity prevalence rates for children.