Body Mass Index and Outcomes in Critically Injured Blunt Trauma Patients: Weighing the Impact

Newell, Mark A.; Bard, Michael R.; Goettler, Claudia E.; Toschlog, Eric A.; Schenarts, Paul J.; Sagraves, Scott G.; Holbert, Donald; Pories, Walter J.; Rotondo, Michael F.

doi:10.1016/j.jamcollsurg.2006.12.042

Cited by 148 publications

(131 citation statements)

References 17 publications

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“…Overall, obese patients have twice the relative risk of developing sepsis, UTI, or respiratory infections in the trauma/ICU setting [1]. In comparing normal BMI to a BMI of 30-39.9 with an ISS ≥ 16 there is a 1.72 odds ratio for pneumonia and 1.82 for urinary tract infections [4]. In the ICU population 61% of obese patients had infections compared to 34% in the non-obese group [1].…”

Section: Discussionmentioning

confidence: 99%

“…From 2011 to 2012, 35% of adults in the United States met criteria to be considered obese [3]. Obesity is defined as having a body mass index (BMI) between 30 kg/m 2 and 39.9 kg/m 2 , and morbidly obese as having a BMI greater than or equal to 40 kg/m 2 [4]. Obesity is often considered a risk factor for patients with serious injuries because it is usually associated with other comorbid conditions including heart disease, malignant neoplasm, stroke, chronic lower respiratory disease, diabetes mellitus, influenza, and pneumonia [5].…”

Section: Introductionmentioning

confidence: 99%

“…Recent literature exploring the link between obesity and trauma has shown increased morbidity and complications in obese trauma patients [1,4,7,8,9]. However, despite abundant literature on obesity, the results of studies looking at trauma outcomes and how they may be impacted by obesity are inconsistent [10].…”

Section: Introductionmentioning

confidence: 99%

“…One such study found that morbidly obese trauma patients had increased odds of post-operative complications including pneumonia and urinary tract infection (UTI) compared to patients with a normal BMI [4]. These types of complications can increase the cost associated with trauma care and elevate the severity of infectious complications as over 70% of deaths from nosocomial infections are a result of surgical site infection (SSI) [12,13].…”

Section: Introductionmentioning

confidence: 99%

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Infectious complications in obese patients after trauma

Bell

Bayt

Siedlecki

et al. 2016

Journal of Surgical Research

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Background: Obesity is a public health concern in the U.S. due to its increasing prevalence, especially in younger age groups. Trauma is the most common cause of death for people under 40 years of age. The purpose of this study is to determine the association between obesity and specific infectious complications following traumatic injury. Materials and Methods:A retrospective analysis was conducted using data from the 2012 National Trauma Data Bank (NTDB). The NTDB defined obesity as having a BMI of 30 or greater. Descriptive statistics were calculated and stratified by obesity status. A hierarchical regression model was used to determine the odds of experiencing an infectious complication in patients with obesity while controlling for age, gender, diabetes, number of comorbidities, injury severity, injury mechanism, head injury, and surgical procedure. Results:Patients with a BMI of 30 or greater compared to non-obese patients had increased odds of having an infectious complication (OR=1.59, 1.49-1.69). In addition to obesity, ISS greater than 29, age 40 years or older, diabetes, comorbid conditions, and having a surgical procedure were also predictive of an infectious complication. Conclusions:Our results indicate that trauma patients with obesity are nearly 60% more likely to develop an infectious complication in the hospital. Infection prevention and control measures should be implemented soon after hospital arrival for patients with obesity, particularly those with operative trauma.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Infectious complications in obese patients after trauma

Bell

Bayt

Siedlecki

et al. 2016

Journal of Surgical Research

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show abstract

“…14 Multiple studies have reviewed the association between obesity and trauma outcomes (eg, ICU and hospital length of stay [LOS], mortality), with varied results. [15][16][17][18][19][20] Single institutional studies have concluded that obese patients experiencing traumatic injuries have a higher incidence of complications, 15 increased risk for ventilator support, 20 and longer hospitalizations 15,20 for comparable injury severity scores (ISS) than those with normal BMIs. 15 In contrast, other studies have determined that there are no differences in total ventilation days or PICU LOS 18 and found no association with mortality 15,19 after adjusting for ISS 17 in obese pediatric patients.…”

mentioning

confidence: 99%