title: Morbid obesity impacts mortality in blunt trauma.
abstract: Twenty-six per cent of adults in the Unites States are obese and trauma remains a major cause of death. We assessed the impact of morbid obesity on mortality in patients with blunt trauma. We reviewed the records of patients with a body mass index 40 kg/m2 or greater injured by blunt trauma from 1993 to 2003 and compared them with a 4:1 control population with a normal body mass index and matched for sex and constellation of injuries. For comparison, patients were categorized by Injury Severity Score 9 or less or Injury Severity Score 10 or greater. Student t test and chi2 were used for statistical analysis. P < 0.05 was considered significant. One hundred seven morbidly obese patients were identified and compared with 458 control subjects with a normal body mass index and matched for sex and constellation of injuries. Although the morbidly obese patients were found to be significantly younger, those who incurred multiorgan injury experienced a significantly longer hospital length of stay and displayed a greater than fourfold increase in mortality when compared with the control subjects. Furthermore, the number of morbidly obese patients admitted over the 10-year period significantly increased by fourfold (0.4% to 1.5%). Over the last decade, there has been a significant increase in morbidly obese patients cared for in our trauma center. Although these patients were significantly younger with a similar Glasgow Coma Score as that of the control population, morbid obesity significantly increased mortality when the injury from blunt trauma transitioned from a single to a multiorgan injury.
authors: Department of Surgery, University of Louisville, Louisville, Kentucky, USA. ashley.christmas@carolinashealthcare.org
authors: A Britton
authors: AB
authors: Christmas
authors: Jennifer
authors: J
authors: Reynolds
authors: Ashley K
authors: AK
authors: Wilson
authors: Glen A
authors: GA
authors: Franklin
authors: Frank B
authors: FB
authors: Miller
authors: J David
authors: JD
authors: Richardson
authors: Jorge L
authors: JL
authors: Rodriguez
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000401:mortality*