Body mass index in blunt trauma patients with hemorrhagic shock: Opposite ends of the body mass index spectrum portend poor outcome

John O. Hwabejire, Christine E. Nembhard, Augustine C. Obirieze, Tolulope A. Oyetunji, Daniel D. Tran, Terrence M. Fullum, Suryanarayana M. Siram, Edward E. Cornwell, Wendy R. Greene*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)659-665
Number of pages7
JournalAmerican Journal of Surgery
Volume209
Issue number4
DOIs
StatePublished - Jan 1 2015

Keywords

  • Blunt trauma
  • Body mass index
  • Hemorrhagic shock
  • Mortality
  • Obesity
  • Underweight

ASJC Scopus subject areas

  • Surgery

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