Association of Body Mass Index on Injuries and Outcomes After Ground-Level Falls

Area of Science:

• Trauma Surgery
• Orthopedic Surgery
• Public Health

Background:

• The relationship between body mass index (BMI) and trauma severity following ground-level falls (GLF) requires clarification.
• Understanding these associations is crucial for optimizing patient care and outcomes.

Purpose of the Study:

• To investigate the impact of BMI on injury patterns and mortality in patients experiencing GLF.
• To determine if different BMI categories influence trauma severity and treatment needs.

Main Methods:

• Analysis of a large trauma registry (TQIP database, 2013-2017) including patients aged 16 years and older.
• Patients were categorized into BMI groups: Underweight (<18.5), Normal (18.5-24.9), Overweight (25.0-29.9), and Obese (≥30).
• Exclusion criteria included transfers, in-hospital death, severe injuries (AIS 6), and missing data.

Main Results:

• The Obese group exhibited lower fracture rates, especially femur fractures, compared to the Normal BMI group (53% vs. 64%).
• Obese patients required orthopedic surgical intervention more frequently (45% vs. 41%).
• Overweight BMI was associated with a protective effect against mortality (OR 0.881), while obesity showed no significant association (OR 1.012).

Conclusions:

• Elevated BMI may confer protection against fractures and mortality post-GLF.
• Obese individuals necessitate more frequent operative fixation, highlighting potential challenges in diagnosis.
• Enhanced vigilance during tertiary surveys is recommended for obese patients after GLF to prevent missed injuries.