Impact of Body Mass Index on Adverse Events in Children Undergoing Sedation for MRI.

Abstract

Objectives: More than 20% of children in the United States have a nonhealthy body mass index (BMI). Magnetic resonance imaging is a common procedure necessitating sedation in children, including those with nonhealthy BMI values. We aimed to determine the risk of adverse events (AEs) and airway interventions associated with BMI in this population.

Methods: A retrospective cross-sectional study of children undergoing sedation for MRI at 66 centers participating in the Pediatric Sedation Research Consortium was conducted. BMI values were categorized as underweight, healthy weight, overweight, obesity, and severe obesity. Outcomes were AEs and airway interventions. AEs were categorized as major, moderate, or minor, and airway interventions were categorized as major or minor. We used multivariable logistic regression to determine the risk of AEs and airway interventions associated with BMI.

Results: We analyzed 39 393 children; 3132 (8%) were underweight, 5476 (13.9%) were overweight, 4446 (11.2%) had obesity, and 1123 (2.9%) had severe obesity. Risk of major and moderate AEs in children categorized as underweight, overweight, obesity, and severe obesity were adjusted odds ratio (aOR) 1.22 (95% CI: 1.04-1.4), 1.58 (95% CI 1.41-1.74), 1.8 (95% CI 1.55-2.04), and 1.86 (95% CI 1.59-2.13), respectively. Risk of major airway interventions in those with BMI values in the overweight, obesity, and severe obesity categories were aOR 1.61 (95% CI 1.44-1.78), 1.83 (95% CI 1.58-2.09), and 1.9 (95% CI 1.62-2.18).

Conclusions: Children undergoing sedation for MRI categorized as overweight, obesity, and severe obesity are at increased odds of AEs and airway interventions. Children who are underweight have increased odds of AEs.