title: Obesity and trauma mortality: Sizing up the risks in motor vehicle crashes.
abstract: Protective effects of safety devices in obese motorists in motor vehicle collisions (MVC) remain unclear. Aim of our study is to assess the association between morbid obesity and mortality in MVC, and to determine the efficacy of protective devices. We hypothesised that patients with morbid obesity will be at greater risk of death after MVC.
  
  
  
  A retrospective analysis of MVC patients (age ≥16 y.o.) was performed using the National Trauma Data Bank from 2007 to 2010. Patients with recorded comorbidity of morbid obesity (BMI≥40) were identified. Patients dead on arrival, with isolated traumatic brain injury, or incomplete data were excluded. The primary outcome was in-hospital mortality. Multivariate logistic regression was performed.
  
  
  
  Our sample of 214,306 MVC occupants included 10,260 (4.8%) morbidly obese patients. Mortality risk was greatest among occupants with morbid obesity (ORcrude1.74 [1.54-1.98]). After adjusting for patient demographics, safety device and physiological severity, odds of death was 1.52 [1.33-1.74] times greater in motorists with morbid obesity. Motorists with morbid obesity were at greater risk of death if no restraint (OR 1.84 [1.47-2.31]), seatbelt only (OR 1.48 [1.17-1.86]), or both seatbelt and airbag were present (OR 1.49 [1.13-1.97]). No significant differences in the odds of death exist between drivers with morbid obesity and non-morbidly obese drivers with only airbag deployment (OR 0.99 [0.65-1.51]).
  
  
  
  Motorists with morbid obesity are at greater risk of MVC. Regardless of safety device use, occupants with morbid obesity remained at greater risk of death. Further research examining the effectiveness of vehicle restraints in drivers with morbid obesity is warranted.
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States. Electronic address: bjoseph@surgery.arizona.edu.
authors.forename: Bellal
authors.initials: B
authors.lastname: Joseph
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States.
authors.forename: Steven
authors.initials: S
authors.lastname: Hadeed
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States.
authors.forename: Ansab A
authors.initials: AA
authors.lastname: Haider
authors.affiliation: Department of Surgery, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA, United States.
authors.forename: Michael
authors.initials: M
authors.lastname: Ditillo
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States.
authors.forename: Aly
authors.initials: A
authors.lastname: Joseph
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States.
authors.forename: Viraj
authors.initials: V
authors.lastname: Pandit
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States.
authors.forename: Narong
authors.initials: N
authors.lastname: Kulvatunyou
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States.
authors.forename: Andrew
authors.initials: A
authors.lastname: Tang
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States.
authors.forename: Rifat
authors.initials: R
authors.lastname: Latifi
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States.
authors.forename: Peter
authors.initials: P
authors.lastname: Rhee
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017278:Air Bags; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles; D009767:Obesity, Morbid / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D012622:Seat Belts; D014947:Wounds and Injuries / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control; D055815:Young Adult
keywords: Mortality; Motor vehicle collision; Obesity