Body mass index in blunt trauma patients with hemorrhagic shock: opposite ends of the body mass index spectrum portend poor outcome.
BACKGROUND: There are controversial data on the relationship between trauma and body mass index. We investigated this relationship in traumatic hemorrhagic shock.
METHODS: The "Glue Grant" database was analyzed, stratifying patients into underweight, normal weight (NW), overweight, Class I obesity, Class II obesity, and Class III obesity. Predictors of mortality and surgical interventions were statistically determined.
RESULTS: One thousand nine hundred seventy-six patients were included with no difference in injury severity between groups. Marshall's score was elevated in overweight (5.3 ± 2.7, P = .016), Class I obesity (5.8 ± 2.7, P < .001), Class II obesity (5.9 ± 2.8, P < .001), and Class III obesity (6.3 ± 3.0, P < .001) compared with NW (4.8 ± 2.6). Underweight had higher lactate (4.8 ± 4.2 vs 3.3 ± 2.5, P = .04), were 4 times more likely to die (odds ratio 3.87, confidence interval 2.22 to 6.72), and were more likely to undergo a laparotomy (odds ratio 2.06, confidence interval 1.31 to 3.26) than NW.
CONCLUSION: Early assessment of body mass index, with active management of complications in each class, may reduce mortality in traumatic hemorrhagic shock.
American journal of surgery
Adult; Body Mass Index; Female; Humans; Male; Overweight; Retrospective Studies; Shock; Hemorrhagic; Thinness; Wounds; Nonpenetrating
BMI; Hemorrhagic shock; Blunt Trauma; Mortality; Surgical Outcomes
Hwabejire, John O.; Nembhard, Christine E.; Obirieze, Augustine C.; Oyetunji, Tolulope A.; Tran, Daniel D.; Fullum, Terrence M.; Siram, Suryanarayana M.; Cornwell, Edward E.; and Greene, Wendy R., "Body mass index in blunt trauma patients with hemorrhagic shock: opposite ends of the body mass index spectrum portend poor outcome." (2015). Manuscripts, Articles, Book Chapters and Other Papers. 40.