The impact of body mass index on the physiology of patients with polytrauma

J Crit Care. 2012 Dec;27(6):722-6. doi: 10.1016/j.jcrc.2012.07.028. Epub 2012 Oct 17.

Abstract

Purpose: Obesity is a growing problem in industrial nations. The aim was to test the hypothesis that overweight patients face early physiologic impairment.

Methods: A total of 651 patients were included in this retrospective study, with an injury severity score greater than 16 and 16 years or older. The sample was subdivided into 3 groups: body mass index (BMI) less than 25 kg/m(2), BMI of 25 to 30 kg/m(2), and BMI greater than 30 kg/m(2). Physiologic scores-Murray, Goris, Marshall and Sequential Organ Failure Assessment scores-were analyzed at admission and at the day of their maximum. Analysis of variance and χ(2) tests were used, and the significance level was set at P < .05.

Results: All 4 scores showed significant differences at their maxima according to the 3 BMI groups, respectively: Murray score (P < .001), Goris score (P < .05), Marshall score (P < .001), and Sequential Organ Failure Assessment score (P <.05). The injury severity score values of the 3 groups at admission were 27.6 ± 12.0, 29.6 ± 13.2, and 25.3 ± 9.2, respectively (P < .05). The overall mortality rates in the 3 groups were 15.1%, 21.0%, and 20%, respectively (P < .001).

Conclusions: Anticipating BMI-specific critical trauma problems will become mandatory for effective polytrauma treatment in industrialized nations given their increasing prevalence of obesity.

MeSH terms

  • Adult
  • Body Mass Index*
  • Female
  • Humans
  • Injury Severity Score*
  • Male
  • Middle Aged
  • Overweight / epidemiology*
  • Overweight / mortality
  • Retrospective Studies
  • Treatment Outcome
  • Wounds and Injuries / epidemiology*
  • Wounds and Injuries / mortality