Effect of Body Mass Index on trauma severity and prognosis in trauma patients

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/m2, normal 18.5 to 24.9 kg/m2, overweight 25.0 to 29.9 kg/m2, or obese greater than 30 kg/m2. 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/m2) 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.

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Body Mass Index and Outcomes in Critically Injured Blunt Trauma Patients: Weighing the Impact

Yearbook of Surgery ◽

10.1016/s0090-3671(08)79164-x ◽

2008 ◽

Vol 2008 ◽

pp. 36

Author(s):

D.W. Mozingo

Keyword(s):

Body Mass Index ◽

Blunt Trauma ◽

Body Mass ◽

Trauma Patients ◽

The Impact

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16 RELATIONSHIP OF BODY MASS INDEX TO OUTCOME IN CRITICALLY ILL TRAUMA PATIENTS

Journal of Investigative Medicine ◽

10.2310/6650.2005.00206.15 ◽

2005 ◽

Vol 53 (2) ◽

pp. S359.4-S359

Author(s):

J. G. Zein ◽

E. A. Chbeir ◽

M. M. Tawk ◽

G. T. Kinasewitz

Keyword(s):

Body Mass Index ◽

Critically Ill ◽

Body Mass ◽

Trauma Patients ◽

Relationship Of

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

The American Surgeon ◽

10.1177/00031348211024640 ◽

2021 ◽

pp. 000313482110246

Author(s):

Natthida Owattanapanich ◽

Morgan Schellenberg ◽

Emily Switzer ◽

Damon H. Clark ◽

Kazuhide Matsushima ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Surgical Intervention ◽

Ground Level ◽

Study Groups ◽

Trauma Severity ◽

Femur Fractures ◽

Fracture Diagnosis ◽

Operative Fixation ◽

The Impact

Background The impact of body mass index (BMI) on trauma severity after ground-level falls (GLF) is currently unclear. This study aimed to examine the associations between BMI, injuries, and outcomes after GLF. Study Design All patients ≥16 years of age injured by GLF were queried from the TQIP database (2013-2017). Exclusions were transfers, emergency department death, AIS 6 in any region, and missing data. Body mass index defined study groups: Underweight (BMI<18.5), Normal (BMI 18.5-24.9), Overweight (25.0-29.9), and Obese (≥30). Results After exclusions, 131 570 patients remained for analysis. Most patients had a normal BMI (n = 58 503, 44%). Median ISS was 9 [IQR 9-10] in all groups. The Obese group had significantly lower rates of fractures than the Normal group, particularly femur fractures (53% vs. 64%, P < .001), but required orthopedic surgical intervention more frequently (45% vs. 41%, P < .001). On multivariate analysis, being overweight was protective against mortality (OR .881, P = .005), while obesity was not associated with mortality (OR 1.012, P = .821). Conclusion Increasing BMI may be protective against both fracture risk and mortality after GLF. However, obese patients require operative fixation more frequently. Particularly as fracture diagnosis may be more challenging in the obese, special care should be taken during their tertiary surveys after GLF to ensure injuries are not missed.

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