Body mass index affects time to definitive closure after damage control surgery
Ramanath N Haricharan1, Adam C Dooley, Jordan A Weinberg
1Section of Trauma, Burns and Surgical Critical Care, Department of Surgery, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
The Journal of Trauma
|June 11, 2009
Summary
Obesity significantly increases complications and prolongs recovery for trauma patients needing damage control laparotomy (DCL). Overweight and obese individuals face longer hospital stays and delayed abdominal closure.
Area of Science:
- Trauma Surgery
- Surgical Critical Care
- Obesity Medicine
Background:
- Obesity is linked to worse outcomes after trauma, but its specific impact on damage control laparotomy (DCL) closure time is unquantified.
- Clinical observations suggest obesity delays definitive abdominal closure in DCL patients.
Purpose of the Study:
- To quantitatively assess the association between body mass index (BMI) and outcomes in trauma patients undergoing DCL.
- To compare time to definitive abdominal closure, complication rates, and intensive care unit (ICU) stay between normal weight and overweight/obese DCL patients.
Main Methods:
- Retrospective review of 148 patients undergoing DCL at an academic Level I trauma center (2002-2006).
- Comparison of demographic, injury, and clinical characteristics, including complication risks (pneumonia, renal failure, sepsis), ICU stay, and time to abdominal closure.
- Stratification based on body mass index (BMI) into normal weight and overweight/obese categories.
Main Results:
- Overweight and obese patients had significantly higher risks of pneumonia, sepsis, and renal failure compared to normal BMI patients.
- Obese patients experienced longer ICU stays (28.7 vs. 15.1 days) and hospitalizations (39.3 vs. 27.0 days).
- Time to definitive abdominal closure was significantly prolonged in obese patients (8.4 vs. 3.9 days).
Conclusions:
- Overweight and obesity are associated with delayed definitive abdominal closure in patients requiring DCL.
- Obese trauma patients undergoing DCL face increased risks of pneumonia and prolonged ICU stays.
- These findings highlight the importance of considering BMI in managing DCL patients.
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