Obesity in trauma: outcomes and disposition trends

Am J Surg. 2014 Mar;207(3):387-92; discussion 391-2. doi: 10.1016/j.amjsurg.2013.10.013. Epub 2013 Dec 19.

Abstract

Background: Obesity's effect on the outcomes of trauma patients remains inconclusive.

Methods: A retrospective review of all falls, motor vehicle collisions (MVCs), and penetrating trauma patients admitted from January 2008 to December 2012 was performed. The outcomes evaluated included mortality, length of stay at hospital, and discharge disposition. Patients were grouped according to the body mass index (BMI) and stratified by injury severity scores.

Results: Two thousand one hundred ninety six patients were analyzed; 132 penetrating, 913 falls, and 1,151 MVCs. Penetrating traumas had no significant difference in outcomes. In falls, obese patients had a lower mortality (P = .035). In MVCs, obese patients had longer hospitalizations (P = .02), and mild and moderate MVC injuries were less likely to be discharged home (P = .032 and .003). Obese patients sustained fewer head injuries in falls and MVCs (P = .005 and .043, respectively).

Conclusions: In falls, a higher BMI may benefit patients. However, an increasing BMI is associated with a longer length of stay at hospital, and decreased likelihood of discharge to home.

Keywords: Blunt trauma; Body mass index; Fall; Motor vehicle collision; Obesity; Wounds and injuries.

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Accidents, Traffic / statistics & numerical data*
  • Body Mass Index
  • Comorbidity
  • Humans
  • Illinois / epidemiology
  • Injury Severity Score
  • Length of Stay
  • Obesity / complications*
  • Obesity / epidemiology
  • Outcome Assessment, Health Care
  • Patient Discharge / statistics & numerical data
  • Registries
  • Retrospective Studies
  • Wounds and Injuries / epidemiology
  • Wounds, Penetrating / epidemiology*