The effect of obesity on outcomes in trauma patients: A meta-analysis
Section snippets
Search strategy
This study was conducted according to the guideline from the meta-analysis of observational studies in epidemiology (MOOSE) group.18 English-language articles published in Web of Science, PubMed and Cochrane Library up to June 2012 were searched using the following strategy: (‘obesity’ or ‘obese’ or ‘body mass index’) and (‘trauma’ or ‘injury’). References cited by chosen articles were checked manually for any other potential studies.
Study selection and data extraction
Studies chosen for the analysis fulfilled the following
Results
Our search strategy identified 2073 potentially relevant publications. Twenty-six of these publications met the inclusion criteria after the abstract review and were chosen for a full-text review. Upon closer examination, another eight studies were ruled out for the following reasons: definition of obesity using a different criterion (BMI > 40 kg m−2)26, 27; use of overlapping data with a smaller cohort and a shorter study period21, 28; inclusion of patients with specific injury patterns (such as
Discussion
There were two meta-analyses in past 5 years investigating the outcomes in obese patients in the critical care setting.33, 34 To our knowledge, despite strong heterogeneity among studies about the influence of obesity in trauma patients, there has been no meta-analysis in this field. The reason for the discrepancy in prior published studies had not been fully elucidated. A common shortcoming of these studies was that a substantial number of patients had to be excluded because of the lack of
Conclusion
The evidence presented here strongly supports the association of obesity with higher mortality in trauma patients despite comparable injury severity. The post-injury course for obese trauma patients is more complicated, characterised by extended ICU length of stay and increased rate of ARDS, acute renal failure and MOF. These findings might lead to potential therapeutic targets to improve outcomes in obese trauma patients.
Conflict of interest
This studied was supported by the Ministry Of Health Industry Special Fund of China (NO. 201002014) and the National key Technology R&D Program (Grant NO. 2012BAI11B00). The study was also funded by Wuhan Planning Project of Science and Technology (NO. 201161038339-03).
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