title: Impact of the body mass on complications and outcome in multiple trauma patients: what does the weight weigh?
abstract: Obesity is known as an independent risk factor for various morbidities. The influence of an increased body mass index (BMI) on morbidity and mortality in critically injured patients has been investigated with conflicting results. To verify the impact of weight disorders in multiple traumatized patients, 586 patients with an injury severity score >16 points treated at a level I trauma center between 2005 and 2011 were differentiated according to the BMI and analyzed regarding morbidity and outcome. Plasma levels of interleukin- (IL-) 6 and C-reactive protein (CRP) were measured during clinical course to evaluate the inflammatory response to the "double hit" of weight disorders and multiple trauma. In brief, obesity was the highest risk factor for development of a multiple organ dysfunction syndrome (MODS) (OR 4.209, 95%-CI 1.515-11.692) besides injury severity (OR 1.054, 95%-CI 1.020-1.089) and APACHE II score (OR 1.059, 95%-CI 1.001-1.121). In obese patients as compared to those with overweight, normal weight, and underweight, the highest levels of CRP were continuously present while increased systemic IL-6 levels were found until day 4. In conclusion, an altered posttraumatic inflammatory response in obese patients seems to determine the risk for multiple organ failure after severe trauma.
authors.affiliation: Department of Trauma and Reconstructive Surgery, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
authors.forename: Hagen
authors.initials: H
authors.lastname: Andruszkow
authors.forename: Juliane
authors.initials: J
authors.lastname: Veh
authors.forename: Philipp
authors.initials: P
authors.lastname: Mommsen
authors.forename: Christian
authors.initials: C
authors.lastname: Zeckey
authors.forename: Frank
authors.initials: F
authors.lastname: Hildebrand
authors.forename: Michael
authors.initials: M
authors.lastname: Frink
mesh_terms: D052242:Adiponectin / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000150:complications* / Q000401:mortality / Q000503:physiopathology*; D009104:Multiple Trauma / Q000150:complications* / Q000401:mortality / Q000503:physiopathology*; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D052242:Adiponectin; D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein
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