title: The effect of body mass index on posttraumatic transfusion after pelvic trauma.
abstract: The impact of body mass index (BMI) on posttraumatic blood transfusion after pelvic trauma is not well known. We conducted a retrospective review of trauma registry data over a 5-year period. Patients were stratified by BMI as normal: less than 25 kg/m(2), overweight: 25 to 29.9 kg/m(2), obese: 30 to 39.9 kg/m(2), and morbidly obese: 40 kg/m(2) or greater. Fractures were identified as "likely to receive transfusion" based on literature. Multivariable logistic regression modeling evaluated the relationship between BMI and initial posttraumatic transfusion. A second regression model was created to test the effect of BMI after adjusting for fractures "less likely to receive transfusion." Sixty-six of 244 patients (27.3%) received transfusion (mean: 1.1 ± 2.3 units). Morbid obesity was associated with transfusion (less than 55.6 vs 24.8%; P < 0.05) and units of total blood transfused (2.2 ± 2.9 vs 1.0 ± 2.2 mL; P < 0.05). The average age of patients who received a blood transfusion was significantly older compared with patients who did not receive a transfusion (45.4 ± 18.8 vs 36.1 ± 16.1 years; P < 0.05). After adjusting for potential confounders, morbid obesity was a significant risk factor for transfusion (odds ratio [OR], 4.1; 95% confidence interval [CI], 1.4 to 12.0). Adjusting by age and fracture patterns "less likely to receive transfusion," morbid obesity remained a risk factor for transfusion (OR, 4.5; 95% CI, 1.5 to 12.9). Morbid obesity represented a significant risk factor for posttraumatic transfusion in isolated pelvic trauma, even for fracture patterns "less likely to receive transfusion."
authors.affiliation: Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: Justin E
authors.initials: JE
authors.lastname: Richards
authors.forename: Brent J
authors.initials: BJ
authors.lastname: Morris
authors.forename: Oscar D
authors.initials: OD
authors.lastname: Guillamondegui
authors.forename: Kyle R
authors.initials: KR
authors.lastname: Sweeney
authors.forename: Marc A
authors.initials: MA
authors.lastname: Tressler
authors.forename: William T
authors.initials: WT
authors.lastname: Obremskey
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Kregor
mesh_terms: D000077:Acetabulum / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D015992:Body Mass Index; D050723:Fractures, Bone / Q000150:complications / Q000601:surgery*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D016017:Odds Ratio; D010388:Pelvis / Q000293:injuries*; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000601:surgery*; D055815:Young Adult