title: Obesity is an independent risk factor of mortality in severely injured blunt trauma patients.
abstract: 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.
authors.affiliation: 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
authors.forename: Angela L
authors.initials: AL
authors.lastname: Neville
authors.forename: Carlos V R
authors.initials: CV
authors.lastname: Brown
authors.forename: Janie
authors.initials: J
authors.lastname: Weng
authors.forename: Demetrios
authors.initials: D
authors.lastname: Demetriades
authors.forename: George C
authors.initials: GC
authors.lastname: Velmahos
mesh_terms: 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