Obesity in Trauma Patients: Correlations of Body Mass Index with Outcomes, Injury Patterns, and Complications

Current understanding of the effects of obesity on trauma patients is incomplete. We hypothesized that among older trauma patients, obese patients differ from nonobese patients in injury patterns, complications, and mortality. Patients older than 45 years old presenting to a Level I trauma center we...

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Bibliographic Details
Published in:The American surgeon 2011-08, Vol.77 (8), p.1003-1008
Main Authors: EVANS, David C, STAWICKI, Stanislaw P. A, DAVIDO, H. Tracy, EIFERMAN, Daniel
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Body Mass Index
Clinical outcomes
Cohort Studies
Comorbidity
Female
Follow-Up Studies
General aspects
Hospital Mortality - trends
Hospitals
Humans
Injury Severity Score
Kaplan-Meier Estimate
Length of Stay - trends
Logistic Models
Male
Medical sciences
Metabolic diseases
Middle Aged
Mortality
Multivariate Analysis
Obesity
Obesity - diagnosis
Obesity - epidemiology
Postoperative Complications - epidemiology
Postoperative Complications - physiopathology
Registries
Retrospective Studies
Risk Assessment
Sex Factors
Trauma
Trauma Centers
Treatment Outcome
Wound Healing - physiology
Wounds and Injuries - diagnosis
Wounds and Injuries - epidemiology
Wounds and Injuries - surgery
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Summary:Current understanding of the effects of obesity on trauma patients is incomplete. We hypothesized that among older trauma patients, obese patients differ from nonobese patients in injury patterns, complications, and mortality. Patients older than 45 years old presenting to a Level I trauma center were included in this retrospective database analysis (n = 461). Body mass index (BMI) groups were defined as underweight less than 18.5 kg/m(2), normal 18.5 to 24.9 kg/m(2), overweight 25.0 to 29.9 kg/m(2), or obese greater than 30 kg/m(2). Injury patterns, complications, and outcomes were analyzed using univariate analyses, multivariate logistic regression, and Kaplan-Meier survival analysis. Higher BMI is associated with a higher incidence of torso injury and proximal upper extremity injuries in blunt trauma (n = 410). All other injury patterns and complications (except anemia) were similar between BMI groups. The underweight (BMI less than 18.5 kg/m(2)) group had significantly lower 90-day survival than other groups (P < 0.05). BMI is not a predictor of morbidity or mortality in multivariate analysis. Among older blunt trauma patients, increasing BMI is associated with higher rates of torso and proximal upper extremity injuries. Our study suggests that obesity is not an independent risk factor for complications or mortality after trauma in older patients. Conversely, underweight trauma patients had a lower 90-day survival.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481107700818