ESPE Abstracts

Background: Childhood obesity represents an important public health problem and its diagnosis and management should be based on current guidelines. Prevalence of childhood obesity in Romania is one of the lowest in Europe but with a positive trend.

Aim: The aim of the current study was to analyze the implementation of the recommendations of the 2017 Endocrine Society Clinical Practice Guideline on Assessment, Treatment and Prevention of Pediatric Obesity in a tertiary Endocrinology center from Targu-Mures, Romania.

Material and Methods: Electronic health records (EHR) of children aged 1-15 years admitted in the Endocrinology Clinic of Targu-Mures, Romania, between 1st of January 2020 and 31st of December 2021 were reviewed. Data was collected on age, gender, body mass index standard deviation score (BMI SDS), overweight or obesity coded as diagnosis, waist measurement availability, assessment of potential comorbidities (blood pressure, blood glucose, total and fractioned (HDL and LDL) cholesterol, triglycerides and liver enzymes) and attending physician.

Results: A total of 691 EHR were reviewed, out of which 31.1% (215) did not contain any information except demographics and 2.9% din not contain the BMI SDS and were therefore excluded. Prevalence of overweight and obesity in the 476 EHR analyzed was 30.4% (145). Obesity was coded in 76.5% of cases (111) with girls more likely to have the diagnosis missed, regardless of age. Comorbidity assessment was complete in 39 records (26.9%) with cholesterol fractions and blood pressure most often missed, especially in younger age groups. Glucose, total cholesterol and liver enzymes were assessed most often (80%). Waist measurement was recorded in 90.3% of cases. Compliance with recommendations was similar between physicians.

Discussion and conclusions: Compared to data available in the literature, clinical practice in this tertiary center is in compliance with the recommendations of the available guidelines even during the COVID 19 pandemic, but there is still a high percentage of not coded diagnosis and a lack of comorbidity screening, especially blood pressure and cholesterol fractions. The most important issue discovered was the high percentage of missing data in the EHR with the need for future audits in this regard.