ABSTRACT
Objective
Obesity is a risk factor for morbidity and mortality in the polytraumatized patient. The aim of this study is to determine if obesity is an independent risk factor for missed injury in chest X-ray after trauma.
Materials and methods
Institutional Review Board approval was obtained. We performed a retrospective review of patients who presented to a level one trauma center as the higher acuity alerts from September 2010 to July 2011. We compared the chest X-ray with the chest computed tomography (CT) findings. Variables, such as age, BMI, mechanism, admission to the ICU and mortality during the same hospital stay, were evaluated.
Results
A total of 224 patients met these criteria. The majority of patients were of male gender (79%). Average age was 40 years. Average ISS was 19.7. Mean BMI was 26.7 with 103 patients with BMI < 25 and with 123 patients with BMI >25. Mechanisms included blunt (n = 167), penetrating (n = 50) and burns (n = 7). A total of 123 patients (54.4%) had undiagnosed thoracic injuries by chest X-ray that were found on chest CT scan. Eighty-five percent of patients with missed injuries on chest X-ray required ICU admission as a result of the thoracic trauma. Missed injuries were as follows; rib fractures with or without flail chest (n = 62), pneumothorax (n = 40), hemothorax (n = 42), sternal fracture (n = 15), pulmonary lacerations/contusion (n = 60), great vessel injuries (n = 6), and blunt ventricular rupture (n = 1). Strikingly, there was no significant difference in missed injury, ICU admission or mortality when obese patients were compared to nonobese patients.
Conclusion
Chest X-ray undermines the degree of injury in blunt trauma patients. BMI is not an independent predictor of missed injury, ICU admission or mortality during the same hospital stay.
How to cite this article
Vanguri P, Anand R, Aboutanos M, Ivatury R, Ferrada P. Body Mass Index is not an Independent Predictor for Missed Injury on Chest X-ray compared with Chest Computed Tomography. Panam J Trauma Critical Care Emerg Surg 2013;2(1):45-48.