Magazine article Clinical Psychiatry News

Obese Patients Are at Increased Risk for Trauma Complications

Magazine article Clinical Psychiatry News

Obese Patients Are at Increased Risk for Trauma Complications

Article excerpt

PALM BEACH, FLA. -- Obese patients with critical injuries from blunt trauma have worse outcomes than do leaner patients, according to a single-center review of more than 1,500 patients.

However, the new data were not able to show an increased risk for death after blunt trauma in obese patients, Dr. Michael F. Rotondo said at the annual meeting of the Southern Surgical Association.

The findings are notable because the series they come from is the largest ever reported on the role of obesity in trauma outcomes, and includes the highest percentage of obese patients, said Dr. Rotondo, chairman of surgery at East Carolina University in Greenville, N.C.

The study included 1,543 patients treated for blunt trauma at East Carolina between July 2001 and November 2005. All patients had an injury severity score of at least 16. The analysis excluded patients for whom there were inadequate data to calculate a body mass index, and those with a BMI of less than 18.5 kg/[m.sup.2].

Patients with a normal BMI, 18.5-24.9 kg/[m.sup.2], composed 36% of the study group; overweight patients, with a BMI of 25.0-29.9 kg/[m.sup.2], made up 34%; obese patients, with a BMI of 30.0-39.9 kg/[m.sup.2], composed 24%; and morbidly obese patients, with a BMI of 40.0 kg/[m.sup.2] or greater, made up 6% of the group.

The analysis revealed that patients with higher BMIs had significantly increased lengths of stay in both the intensive care unit and the hospital, and also required more days of ventilator support, Dr. Rotondo said.

The patients had a total of 1,386 complications. In an analysis that was adjusted for age, gender, injury severity score, and revised trauma score, patients who were obese or morbidly obese had increased complication rates.

Out of 12 complications analyzed, obese patients had a significantly increased risk for 3 complications (acute respiratory failure, pneumonia, and urinary tract infection) and a nonsignificantly increased risk for 5 complications, whereas morbidly obese patients had a significantly increased risk for 8 complications. (See table.)

Results from prior studies have consistently shown increased morbidity with higher BMI in trauma patients, Dr. Rotondo said. …

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