The impact of obesity on the outcomes of 1,153 critically injured blunt trauma patients

Carlos V R Brown, Angela L. Neville, Peter Rhee, Ali Salim, George C. Velmahos, Demetrios Demetriades

Research output: Contribution to journalArticle

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Abstract

Background: Several small series have had mixed conclusions regarding the impact of obesity on outcomes of trauma patients. The purpose of the present study was to evaluate a large cohort of critically injured patients to better understand the influence of obesity on the outcomes of patients after severe blunt trauma. Methods: Retrospective review using the trauma registry and intensive care unit (ICU) database of all blunt trauma patients admitted to the ICU at our urban, Level I trauma center over a 5-year period (1998-2003). Obese patients (body mass index [BMI] ≥ 30 kg/m2) were compared with non-obese patients (BMI < 30 kg/m2). Results: There were 1,153 blunt trauma patients admitted to the ICU during the study period, including 283 (25%) obese (mean BMI = 35 ± 6 kg/m2) and 870 (75%) non-obese (mean BMI = 25 ± 3 kg/m2) patients. There was no difference between groups regarding age, sex, Injury Severity Score, or admission vitals. Obese patients had fewer head injuries (42 versus 55%; p = 0.0001) but more chest (45 versus 38%; p = 0.05) and lower extremity (53 versus 38%; p < 0.0001) injuries. There was no difference in the need for laparotomy, thoracotomy, or craniotomy. Obese patients suffered more complications (42 versus 32%; p = 0.002). Although there was only a trend toward higher mortality in obese patients (22 versus 17%; p = 0.10), stepwise logistic regression revealed obesity as an independent risk factor for mortality (odds ratio, 1.6; 95% confidence interval, 1.0-2.3; p = 0.03). Among survivors, obese patients required longer stays in the hospital (24 ± 21 versus 19 ± 17 days; p = 0.01), the ICU (13 ± 14 versus 10 ± 10 days; p = 0.005), and 2 more days of mechanical ventilation (8 ± 13 versus 6 ± 9 days; p = 0.07). Conclusion: Obese patients incur different injuries after severe blunt trauma than their non-obese counterparts. Despite sustaining fewer head injuries, obese patients suffer more complications, require longer stays in the hospital, more days of mechanical ventilation, and obesity is independently associated with mortality.

Original languageEnglish (US)
Pages (from-to)1048-1051
Number of pages4
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume59
Issue number5
DOIs
StatePublished - Nov 2005

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Obesity
Wounds and Injuries
Intensive Care Units
Body Mass Index
Craniocerebral Trauma
Artificial Respiration
Mortality
Length of Stay
Injury Severity Score
Craniotomy
Trauma Centers
Thoracotomy
Laparotomy
Survivors
Registries
Lower Extremity
Thorax
Age Groups
Logistic Models
Odds Ratio

ASJC Scopus subject areas

  • Surgery

Cite this

The impact of obesity on the outcomes of 1,153 critically injured blunt trauma patients. / Brown, Carlos V R; Neville, Angela L.; Rhee, Peter; Salim, Ali; Velmahos, George C.; Demetriades, Demetrios.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 59, No. 5, 11.2005, p. 1048-1051.

Research output: Contribution to journalArticle

Brown, Carlos V R ; Neville, Angela L. ; Rhee, Peter ; Salim, Ali ; Velmahos, George C. ; Demetriades, Demetrios. / The impact of obesity on the outcomes of 1,153 critically injured blunt trauma patients. In: Journal of Trauma - Injury, Infection and Critical Care. 2005 ; Vol. 59, No. 5. pp. 1048-1051.
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abstract = "Background: Several small series have had mixed conclusions regarding the impact of obesity on outcomes of trauma patients. The purpose of the present study was to evaluate a large cohort of critically injured patients to better understand the influence of obesity on the outcomes of patients after severe blunt trauma. Methods: Retrospective review using the trauma registry and intensive care unit (ICU) database of all blunt trauma patients admitted to the ICU at our urban, Level I trauma center over a 5-year period (1998-2003). Obese patients (body mass index [BMI] ≥ 30 kg/m2) were compared with non-obese patients (BMI < 30 kg/m2). Results: There were 1,153 blunt trauma patients admitted to the ICU during the study period, including 283 (25{\%}) obese (mean BMI = 35 ± 6 kg/m2) and 870 (75{\%}) non-obese (mean BMI = 25 ± 3 kg/m2) patients. There was no difference between groups regarding age, sex, Injury Severity Score, or admission vitals. Obese patients had fewer head injuries (42 versus 55{\%}; p = 0.0001) but more chest (45 versus 38{\%}; p = 0.05) and lower extremity (53 versus 38{\%}; p < 0.0001) injuries. There was no difference in the need for laparotomy, thoracotomy, or craniotomy. Obese patients suffered more complications (42 versus 32{\%}; p = 0.002). Although there was only a trend toward higher mortality in obese patients (22 versus 17{\%}; p = 0.10), stepwise logistic regression revealed obesity as an independent risk factor for mortality (odds ratio, 1.6; 95{\%} confidence interval, 1.0-2.3; p = 0.03). Among survivors, obese patients required longer stays in the hospital (24 ± 21 versus 19 ± 17 days; p = 0.01), the ICU (13 ± 14 versus 10 ± 10 days; p = 0.005), and 2 more days of mechanical ventilation (8 ± 13 versus 6 ± 9 days; p = 0.07). Conclusion: Obese patients incur different injuries after severe blunt trauma than their non-obese counterparts. Despite sustaining fewer head injuries, obese patients suffer more complications, require longer stays in the hospital, more days of mechanical ventilation, and obesity is independently associated with mortality.",
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AU - Brown, Carlos V R

AU - Neville, Angela L.

AU - Rhee, Peter

AU - Salim, Ali

AU - Velmahos, George C.

AU - Demetriades, Demetrios

PY - 2005/11

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N2 - Background: Several small series have had mixed conclusions regarding the impact of obesity on outcomes of trauma patients. The purpose of the present study was to evaluate a large cohort of critically injured patients to better understand the influence of obesity on the outcomes of patients after severe blunt trauma. Methods: Retrospective review using the trauma registry and intensive care unit (ICU) database of all blunt trauma patients admitted to the ICU at our urban, Level I trauma center over a 5-year period (1998-2003). Obese patients (body mass index [BMI] ≥ 30 kg/m2) were compared with non-obese patients (BMI < 30 kg/m2). Results: There were 1,153 blunt trauma patients admitted to the ICU during the study period, including 283 (25%) obese (mean BMI = 35 ± 6 kg/m2) and 870 (75%) non-obese (mean BMI = 25 ± 3 kg/m2) patients. There was no difference between groups regarding age, sex, Injury Severity Score, or admission vitals. Obese patients had fewer head injuries (42 versus 55%; p = 0.0001) but more chest (45 versus 38%; p = 0.05) and lower extremity (53 versus 38%; p < 0.0001) injuries. There was no difference in the need for laparotomy, thoracotomy, or craniotomy. Obese patients suffered more complications (42 versus 32%; p = 0.002). Although there was only a trend toward higher mortality in obese patients (22 versus 17%; p = 0.10), stepwise logistic regression revealed obesity as an independent risk factor for mortality (odds ratio, 1.6; 95% confidence interval, 1.0-2.3; p = 0.03). Among survivors, obese patients required longer stays in the hospital (24 ± 21 versus 19 ± 17 days; p = 0.01), the ICU (13 ± 14 versus 10 ± 10 days; p = 0.005), and 2 more days of mechanical ventilation (8 ± 13 versus 6 ± 9 days; p = 0.07). Conclusion: Obese patients incur different injuries after severe blunt trauma than their non-obese counterparts. Despite sustaining fewer head injuries, obese patients suffer more complications, require longer stays in the hospital, more days of mechanical ventilation, and obesity is independently associated with mortality.

AB - Background: Several small series have had mixed conclusions regarding the impact of obesity on outcomes of trauma patients. The purpose of the present study was to evaluate a large cohort of critically injured patients to better understand the influence of obesity on the outcomes of patients after severe blunt trauma. Methods: Retrospective review using the trauma registry and intensive care unit (ICU) database of all blunt trauma patients admitted to the ICU at our urban, Level I trauma center over a 5-year period (1998-2003). Obese patients (body mass index [BMI] ≥ 30 kg/m2) were compared with non-obese patients (BMI < 30 kg/m2). Results: There were 1,153 blunt trauma patients admitted to the ICU during the study period, including 283 (25%) obese (mean BMI = 35 ± 6 kg/m2) and 870 (75%) non-obese (mean BMI = 25 ± 3 kg/m2) patients. There was no difference between groups regarding age, sex, Injury Severity Score, or admission vitals. Obese patients had fewer head injuries (42 versus 55%; p = 0.0001) but more chest (45 versus 38%; p = 0.05) and lower extremity (53 versus 38%; p < 0.0001) injuries. There was no difference in the need for laparotomy, thoracotomy, or craniotomy. Obese patients suffered more complications (42 versus 32%; p = 0.002). Although there was only a trend toward higher mortality in obese patients (22 versus 17%; p = 0.10), stepwise logistic regression revealed obesity as an independent risk factor for mortality (odds ratio, 1.6; 95% confidence interval, 1.0-2.3; p = 0.03). Among survivors, obese patients required longer stays in the hospital (24 ± 21 versus 19 ± 17 days; p = 0.01), the ICU (13 ± 14 versus 10 ± 10 days; p = 0.005), and 2 more days of mechanical ventilation (8 ± 13 versus 6 ± 9 days; p = 0.07). Conclusion: Obese patients incur different injuries after severe blunt trauma than their non-obese counterparts. Despite sustaining fewer head injuries, obese patients suffer more complications, require longer stays in the hospital, more days of mechanical ventilation, and obesity is independently associated with mortality.

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