title: The impact of body mass index on the development of systemic inflammatory response syndrome and sepsis in patients with polytrauma.
abstract: OBJECTIVE
  Obesity is a growing problem in industrial nations. Our aim was to examine how overweight patients coped with systemic inflammatory response syndrome (SIRS) after polytrauma.
  
  
  METHODS
  A total of 651 patients were included in this retrospective study, with an ISS ≥ 16 and age ≥ 16 years. The sample was subdivided into three groups: body mass index (BMI; all in kg/m(2))<25, BMI 25-30 and BMI>30, or low, intermediate and high BMI. The SIRS score was measured over 31 days after admission together with measurements of C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT). Data are given as the mean ± SEM if not otherwise indicated. Kruskal-Wallis and χ(2) tests were used for statistical analysis and the significance level was set at p<.05.
  
  
  RESULTS
  The maximum SIRS score was reached in the low BMI-group at 3.4 ± 0.4, vs. 2.3 ± 0.1 and 2.5 ± 0.2 in the intermediate BMI-group and high BMI-group, respectively (p<.0001). However, the maximum SIRS score was reached earlier in the BMI 25-30 group at 1.8 ± 0.2 days, vs. 3.4 ± 0.4 and 2.5 ± 0.2 days in the BMI<25 and BMI>30 groups, respectively (p<.0001). The incidence of sepsis was significantly higher in the low BMI group at 46.1%, vs. 0.2% and 0% in the BMI 25-30 and BMI>30 groups, respectively (p<.0001). No significant differences in the CRP, IL-6 or PCT levels were found between groups.
  
  
  CONCLUSIONS
  A higher BMI seemed to be protective for these patients with polytrauma-associated inflammatory problems.
authors.affiliation: Division of Trauma Surgery, University Hospital of Zürich, Switzerland. Electronic address: ladislav.mica@usz.ch.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Mica
authors.forename: Jindřich
authors.initials: J
authors.lastname: Vomela
authors.forename: Marius
authors.initials: M
authors.lastname: Keel
authors.forename: Otmar
authors.initials: O
authors.lastname: Trentz
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000378:metabolism; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D009765:Obesity / Q000378:metabolism; D011498:Protein Precursors / Q000378:metabolism; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: C000606589:CALCA protein, human; D015850:Interleukin-6; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide