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Citation
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Hwabejire JO, Nembhard CE, Obirieze AC, Oyetunji TA, Tran DD, Fullum TM, Siram SM, Cornwell EE, Greene WR. Am. J. Surg. 2015; 209(4): 659-665. |
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Affiliation
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Department of Surgery, Howard University College of Medicine and Howard University Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA. Electronic address: wgreene@howard.edu. |
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Abstract
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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.
Language: en |