Obesity and increased mortality in blunt trauma

Area of Science:

• Trauma Surgery
• Critical Care Medicine
• Public Health & Epidemiology

Background:

• Admission body weight is a potential factor influencing outcomes in blunt trauma patients.
• Understanding the impact of Body Mass Index (BMI) on trauma outcomes is crucial for clinical management.

Purpose of the Study:

• To investigate the effect of admission body weight, categorized by BMI, on blunt trauma victims.
• To identify predictors of outcome, including BMI and Injury Severity Score (ISS), in trauma patients.

Main Methods:

• Retrospective chart review of 184 blunt trauma patients over 12 years old admitted to Sentara Norfolk General Hospital.
• Calculation of BMI and analysis of demographic data, injuries, ISS, ventilator days (VD), complications, length of stay (LOS), and outcome.
• Groupings based on BMI: average (<27 kg/m2), overweight (27-31 kg/m2), and severely overweight (>31 kg/m2).

Main Results:

• Severely overweight patients exhibited a significantly higher mortality rate (42.1%) compared to average (5.0%) and overweight (8.0%) groups (p < 0.0001).
• BMI and ISS were identified as independent determinants of outcome (p < 0.0001).
• Increased pulmonary complications were observed in the severely overweight group (p < 0.05). Nonsurvivors in the average BMI group had a longer LOS (26.6 days).

Conclusions:

• Admission BMI is a critical factor in blunt trauma outcomes, with severe overweight correlating to increased mortality.
• BMI and ISS are independent predictors of outcome in blunt trauma patients.
• Clinical interventions may be less effective in severely overweight trauma patients who experience rapid deterioration.