Obesity is an independent risk factor of mortality in severely injured blunt trauma patients.
OBJECTIVE
Obesity is associated with increased morbidity and mortality in critically injured blunt trauma patients.


METHODS
Case-control study of all critically injured blunt trauma patients between January 2002 and December 2002.


METHODS
Academic level I trauma center at a county referral hospital.


METHODS
Two hundred forty-two consecutive patients admitted to the intensive care unit following blunt trauma. Patients were divided into 2 groups by body mass index. The obese group was defined as having a body mass index of 30 kg/m2 or higher, and the nonobese group was defined as having a body mass index lower than 30 kg/m2.


METHODS
Univariate and multivariate analyses were performed to identify risk factors for mortality. Complications and length of stay were also evaluated.


RESULTS
Of the 242 patients, 63 (26%) were obese, and 179 (74%) were nonobese. The obese and nonobese groups were similar with regard to age (mean +/- SD, 49 +/- 18 years vs 45 +/- 22 years), male sex (63% vs 72%), Glasgow Coma Scale score (mean +/- SD, 11 +/- 5 vs 11 +/- 5), and injury severity score (mean +/- SD, 21 +/- 13 vs 20 +/- 14). The obese group had a higher body mass index (mean +/- SD, 35 +/- 7 vs 24 +/- 3; P<.001). Mechanisms of injury and injury patterns were similar between groups. The obese group had a higher incidence of multiple organ failure (13% vs 3%; P =.02) and mortality (32% vs 16%; P=.008). Obesity was an independent predictor of mortality with an adjusted odds ratio of 5.7 (95% confidence interval, 1.9-19.6; P=.003).


CONCLUSIONS
Critically injured obese trauma patients have similar demographics and injury patterns as nonobese patients. Obesity is an independent predictor of mortality following severe blunt trauma.
Neville
Angela L
AL
Department of Surgery, Division of Trauma and Critical Care, Los Angeles County, University of Southern California Medical Center, Los Angeles 90033, USA. angelane@usc.edu
Brown
Carlos V R
CV
Weng
Janie
J
Demetriades
Demetrios
D
Velmahos
George C
GC
D015992:Body Mass Index; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications; D012307:Risk Factors; D014949:Wounds, Nonpenetrating / Q000401:mortality* / Q000601:surgery