title: The weight of obesity in patients with lower extremity vascular injuries.
abstract: OBJECTIVE
  Clinical obesity is an epidemic problem in the United States. The impact of this disease upon traumatic lower extremity vascular injuries (LEVI) is as yet undefined. We hypothesized that clinical obesity adversely affects outcome in patients with traumatic LEVI.
  
  
  METHODS
  All adult patients admitted over a 5-year period with a traumatic LEVI were identified. Clinical obesity was defined as body mass index (BMI)>30. Obese and non-obese patient groups were compared for surgical management and outcome.
  
  
  RESULTS
  A total of 145 patients were identified. BMI data were available for 115 (79.3%) of these patients (obese n=47; non-obese n=68). Obese and non-obese groups were similar. Obese patients underwent more vascular repairs but the amputation rate and mortality were not significantly different.
  
  
  CONCLUSIONS
  While obese body habitus can increase the complexity of evaluation and management of patients with LEVI, we have demonstrated that equivalent outcomes to the non-obese population can be achieved for the clinically obese patient with a BMI>30. However, patients with a BMI>40 did reveal a significantly higher chance of amputation and death after LEVI. Due to the small number of patients in this subset, one should use caution when interpreting this data.
authors.affiliation: Section of Trauma and Surgical Critical Care Surgery, The University of Mississippi Medical Center, 2500 N State Street, Jackson, MS 39216, United States. jdsimmons@umc.edu
authors.forename: Jon D
authors.initials: JD
authors.lastname: Simmons
authors.forename: Juan C
authors.initials: JC
authors.lastname: Duchesne
authors.forename: Naveed
authors.initials: N
authors.lastname: Ahmed
authors.forename: Robert E
authors.initials: RE
authors.lastname: Schmieg
authors.forename: Fred W
authors.initials: FW
authors.lastname: Rushton
authors.forename: John M
authors.initials: JM
authors.lastname: Porter
authors.forename: Marc E
authors.initials: ME
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000639:trends; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply* / Q000601:surgery; D008297:Male; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000401:mortality; D016896:Treatment Outcome; D014481:United States; D014656:Vascular Surgical Procedures / Q000009:adverse effects; D057772:Vascular System Injuries