Midwest Surgical AssociationObesity in trauma: outcomes and disposition trends
Section snippets
Methods
A retrospective review of our prospective trauma registry at a state-designated, micro urban, Level I trauma center was used as the primary data source, on the basis of an institutional review board approved protocol. All trauma patients admitted between January 2008 and December 2012 were screened. Patients were excluded if they were under the age of 18 years, pregnant, or sustained burns. All patients who did not have a height, weight, and ISS documented in the registry were also excluded.
Results
The trauma registry contained 3,768 patients for the time period reviewed. Of these, 1,572 required exclusion by age, pregnancy, burn, or incomplete specification of height, weight, and ISS. The remaining 2,196 (58.3%) patients constitute the subjects of this analysis. Of the 1,151 patients injured by MVC, 381 (33.1%) were obese. Of the 913 patients injured by fall, 233 (25.4%) were obese. Of the 132 patients with penetrating injuries, 42 (31.8%) were obese (Fig. 1).
Comments
This study further highlights the complex problems in determining the effects of obesity on patterns of injury and outcomes in obese patients. This study is only descriptive and therefore unable to assess the effects of any particular treatment intervention. It relies on the assumption that injury mechanisms, evaluation, and management techniques are uniform between obese and nonobese populations. The formula for kinetic energy, k = (1/2) mv2, implies that velocity has a much greater effect on
Conclusions
This study demonstrates that the patterns of injury and outcomes for obese trauma patients may be distinct for different mechanisms of injury. We failed to demonstrate significant differences in mortality, LOS, or disposition for victims of penetrating trauma. However, despite similar mortality, obese patients injured by MVC suffered longer hospital stays, longer ICU stays, and more ventilator days than nonobese patients. We unexpectedly found that obese patients injured by a fall of <1 story
References (12)
- et al.
Influence of overweight on ICU mortality: a prospective study
Chest
(2004) - et al.
Impact of obesity in the critically ill patient: a prospective study
J Trauma
(2006) - et al.
Impact of obesity in damage control laparotomy patients
J Trauma
(2009) - et al.
Obesity and increased mortality in blunt trauma
J Trauma
(1991) - et al.
The cushion effect
J Trauma
(2003) - et al.
The effect of obesity on outcomes among injured patients
J Trauma
(2005)
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The authors declare no conflicts of interest.