title: Does obesity increase the risk of injury or mortality in motor vehicle crashes? A systematic review and meta-analysis.
abstract: The objective of this review was to assess the risk of obesity in injuries and fatalities resulting from motor vehicle crash (MVC), as compared with individuals with a normal-range body mass index. A systematic review of the literature was conducted yielding 824 potential studies. Nine of these studies met our inclusion criteria. Meta-analyses examining obesity as a risk factor for various injury types and risk of fatality were conducted using data from these studies. Obesity was associated with higher fatality risk (odds ratio [OR] = 1.89, 95% confidence interval [CI] = 1.51-2.37, P = .0001; pooled estimate from 6 studies), and increased risk of lower extremity fractures (OR = 1.39, 95% CI = 1.18-1.65, P = .0001; pooled estimate from 2 studies). No significant differences were observed when considering abdominal injuries or pelvic fractures. Interestingly, for head injuries obesity was a protective factor (OR = 0.67, 95% CI = 0.46-0.97, P = .0001; pooled data from 3 studies). Evidence strongly supports the association of obesity with higher fatality and fractures of the lower extremities in MVCs. Contrary to our hypothesis, 3 studies showed that obesity was a protective factor in reducing head injuries. Furthermore, the review shows that obesity was not a risk factor of MVC-related pelvic fractures and abdominal injuries.
authors.affiliation: British Columbia Children's Hospital, Vancouver, British Columbia, Canada edesap@cw.bc.ca.
authors.forename: Ediriweera
authors.initials: E
authors.lastname: Desapriya
authors.affiliation: British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Scime
authors.initials: S
authors.lastname: Giulia
authors.affiliation: British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Sayed
authors.initials: S
authors.lastname: Subzwari
authors.affiliation: British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Dinithi C
authors.initials: DC
authors.lastname: Peiris
authors.affiliation: British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Kate
authors.initials: K
authors.lastname: Turcotte
authors.affiliation: British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Ian
authors.initials: I
authors.lastname: Pike
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Deborah
authors.initials: D
authors.lastname: Sasges
authors.affiliation: University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: D Sesath
authors.initials: DS
authors.lastname: Hewapathirane
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality* / Q000706:statistics & numerical data*; D006801:Humans; D009765:Obesity / Q000453:epidemiology*; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology*