title: Utilizing quantitative measures of visceral adiposity in evaluating trauma patient outcomes.
abstract: BACKGROUND
  Body mass index (BMI) has commonly been used as a parameter to assess obesity in trauma patients. However, the variability of height and weight data in trauma patients limits the use of BMI as an accurate assessment tool in the trauma population. Quantitative radiologic measurements of visceral adiposity is an accurate method for assessing obesity in patients but requires further analysis before it can be accepted as a measurement tool for trauma patients.
  
  
  METHODS
  A retrospective review of trauma cases with pre-operative CT scan from 2008 to 2015 produced 57 patients for evaluation. Preoperative BMI was calculated using measured height (m2) and weight (kg). Radiologic measurements of adiposity were obtained from preoperative CT scans using OsiriX DICOM viewer software. Visceral fat areas (VFA) and subcutaneous fat areas (SFA) were measured from a single axial slice at the level of L4-L5 intervertebral space.
  
  
  RESULTS
  No statistically significant results were found relating visceral fat:subcutaneous fat ratios to length of stay or post-operative complications. Initial clinical observations noting an increased incidence of complications among patients with a V/S ≥ 0.4 demonstrates a possible link between obesity and poor outcomes in trauma patients. A statistically significant correlation was noted between length of stay, peri-nephric fat and injury severity score.
  
  
  CONCLUSIONS
  Our pilot study should be viewed as the foundation for a larger prospective study, utilizing quantitative measurements of visceral adiposity to assess outcomes in trauma patients.
authors.affiliation: NYU Lutheran Medical Center, Department of Surgery, 150 55th Street, Brooklyn, NY 11220, USA. Electronic address: sdocimo@gmail.com.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Docimo
authors.affiliation: NYU Lutheran Medical Center, Department of Surgery, 150 55th Street, Brooklyn, NY 11220, USA.
authors.forename: Brooke
authors.initials: B
authors.lastname: Lamparello
authors.affiliation: NYU Lutheran Medical Center, Department of Surgery, 150 55th Street, Brooklyn, NY 11220, USA.
authors.forename: Melissa Fay
authors.initials: MF
authors.lastname: Cohen
authors.affiliation: NYU Lutheran Medical Center, Department of Surgery, 150 55th Street, Brooklyn, NY 11220, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Kopatsis
authors.affiliation: NYU Lutheran Medical Center, Department of Surgery, 150 55th Street, Brooklyn, NY 11220, USA.
authors.forename: Fausto
authors.initials: F
authors.lastname: Vinces
mesh_terms: D050154:Adiposity; D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D008297:Male; D009765:Obesity / Q000150:complications* / Q000175:diagnosis; D063868:Patient Outcome Assessment; D010865:Pilot Projects; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014947:Wounds and Injuries / Q000150:complications* / Q000175:diagnosis
keywords: Adiposity; Quantitative measures; Trauma outcomes; Visceral adiposity