Hypothesis: Obesity is associated with increased morbidity and mortality in critically injured blunt trauma patients.Design: Case-control study of all critically injured blunt trauma patients between January 2002 and December 2002.Setting: Academic level I trauma center at a county referral hospital.Patients: Two hundred forty-two consecutive patients admitted to the intensive care unit following blunt trauma. Patients were divided into 2 groups by body mass index. The obese group was defined as having a body mass index of 30 kg/m 2 or higher, and the nonobese group was defined as having a body mass index lower than 30 kg/m 2 .Main Outcome Measures: Univariate and multivariate analyses were performed to identify risk factors for mortality. Complications and length of stay were also evaluated.Results: Of the 242 patients, 63 (26%) were obese, and 179 (74%) were nonobese. The obese and nonobese groups were similar with regard to age (mean±SD, 49±18 years vs 45±22 years), male sex (63% vs 72%), Glasgow Coma Scale score (mean±SD, 11±5 vs 11±5), and injury severity score (mean±SD, 21±13 vs 20±14). The obese group had a higher body mass index (mean±SD, 35±7 vs 24±3; PϽ.001). Mechanisms of injury and injury patterns were similar between groups. The obese group had a higher incidence of multiple organ failure (13% vs 3%; P=.02) and mortality (32% vs 16%; P=.008). Obesity was an independent predictor of mortality with an adjusted odds ratio of 5.7 (95% confidence interval, 1.9-19.6; P =.003).Conclusions: Critically injured obese trauma patients have similar demographics and injury patterns as nonobese patients. Obesity is an independent predictor of mortality following severe blunt trauma.

Obese patients incur different injuries after severe blunt trauma than their non-obese counterparts. Despite sustaining fewer head injuries, obese patients suffer more complications, require longer stays in the hospital, more days of mechanical ventilation, and obesity is independently associated with mortality.

In mild gallstone pancreatitis, laparoscopic cholecystectomy performed within 48 hours of admission, regardless of the resolution of abdominal pain or laboratory abnormalities, results in a shorter hospital length of stay with no apparent impact on the technical difficulty of the procedure or perioperative complication rate.

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