Body mass index in blunt trauma patients with hemorrhagic shock: opposite ends of the body mass index spectrum portend poor outcome.

Document Type

Article

Publication Date

4-1-2015

Identifier

DOI: 10.1016/j.amjsurg.2014.12.016

Abstract

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.

Journal Title

American journal of surgery

Volume

209

Issue

4

First Page

659

Last Page

665

MeSH Keywords

Adult; Body Mass Index; Female; Humans; Male; Overweight; Retrospective Studies; Shock; Hemorrhagic; Thinness; Wounds; Nonpenetrating

Keywords

BMI; Hemorrhagic shock; Blunt Trauma; Mortality; Surgical Outcomes

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