The impact of body mass index on the physiology of patients with polytrauma.
OBJECTIVE
Obesity is a growing problem in industrial nations. The aim was to test the hypothesis that overweight patients face early physiologic impairment.


METHODS
A total of 651 patients were included in this retrospective study, with an injury severity score greater than 16 and 16 years or older. The sample was subdivided into 3 groups: body mass index (BMI) less than 25 kg/m(2), BMI of 25 to 30 kg/m(2), and BMI greater than 30 kg/m(2). Physiologic scores-Murray, Goris, Marshall and Sequential Organ Failure Assessment scores-were analyzed at admission and at the day of their maximum. Analysis of variance and χ(2) tests were used, and the significance level was set at P < .05.


RESULTS
All 4 scores showed significant differences at their maxima according to the 3 BMI groups, respectively: Murray score (P < .001), Goris score (P < .05), Marshall score (P < .001), and Sequential Organ Failure Assessment score (P <.05). The injury severity score values of the 3 groups at admission were 27.6 ± 12.0, 29.6 ± 13.2, and 25.3 ± 9.2, respectively (P < .05). The overall mortality rates in the 3 groups were 15.1%, 21.0%, and 20%, respectively (P < .001).


CONCLUSIONS
Anticipating BMI-specific critical trauma problems will become mandatory for effective polytrauma treatment in industrialized nations given their increasing prevalence of obesity.
Division of Trauma Surgery, University Hospital of Zürich, Zurich, Switzerland. ladislav.mica@usz.ch
Ladislav
L
Mica
Marius
M
Keel
Otmar
O
Trentz
D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000401:mortality