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Analysis of Mortality in Traumatically Injured Patients Based on Body Mass Index and Mechanism Reveals Highest Mortality among the Underweight in Comparison with the Ideal Weight Patients.

Abstract The purpose of this study was to evaluate the effect of body mass index (BMI) on mortality after traumatic injury. The records of patients from 2012 to 2015 were retrospectively reviewed. The patients were stratified into the following groups based on admission BMI (kg/m2): underweight (UW) (BMI <19), ideal weight (IW) (BMI = 19-24.9), overweight (OW) (BMI = 25-29.9), obese (OB) (BMI = 30-39.9), and morbid obese (MO) (BMI >40). The groups were well matched with no significant differences in demographics and Injury Severity Score. Morality for the IW group was compared with the remaining BMI groups. A total of 6049 patients were identified. In comparison with IW group, the UW mortality was significantly higher (IW vs UW, 4.1% vs 8.8%, P = 0.001); however, the there was no significant difference with remaining groups. There was also no significant difference in mortality between IW and the remaining groups for patients that went directly to the operating room or for patients that had penetrating trauma (stab wounds and gunshot wounds). However, for blunt trauma, the mortality was significantly higher for UW (IW vs UW, 4.3% vs 9.4%, P = 0.001), no different for IW vs OW (4.3% vs 3.7%, P = 0.3), and significantly lower for IW vs OB (4.3% vs 2.8%, P = 0.04) and for IW vs MO (4.3% vs 1.0%, P = 0.03). After traumatic injuries, it is the underweight patients (BMI <19) and not the obese, that are at a significantly higher risk for overall mortality; this difference is especially evident after blunt trauma where obesity may actually confer a protective role.
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Body Mass Index

Keywords
Journal Title the american surgeon
Publication Year Start




PMID- 28424127
OWN - NLM
STAT- MEDLINE
DA  - 20170420
DCOM- 20170501
LR  - 20170501
IS  - 1555-9823 (Electronic)
IS  - 0003-1348 (Linking)
VI  - 83
IP  - 4
DP  - 2017 Apr 01
TI  - Analysis of Mortality in Traumatically Injured Patients Based on Body Mass Index 
      and Mechanism Reveals Highest Mortality among the Underweight in Comparison with 
      the Ideal Weight Patients.
PG  - 341-347
AB  - The purpose of this study was to evaluate the effect of body mass index (BMI) on 
      mortality after traumatic injury. The records of patients from 2012 to 2015 were 
      retrospectively reviewed. The patients were stratified into the following groups 
      based on admission BMI (kg/m2): underweight (UW) (BMI &lt;19), ideal weight (IW)
      (BMI = 19-24.9), overweight (OW) (BMI = 25-29.9), obese (OB) (BMI = 30-39.9), and
      morbid obese (MO) (BMI &gt;40). The groups were well matched with no significant
      differences in demographics and Injury Severity Score. Morality for the IW group 
      was compared with the remaining BMI groups. A total of 6049 patients were
      identified. In comparison with IW group, the UW mortality was significantly
      higher (IW vs UW, 4.1% vs 8.8%, P = 0.001); however, the there was no significant
      difference with remaining groups. There was also no significant difference in
      mortality between IW and the remaining groups for patients that went directly to 
      the operating room or for patients that had penetrating trauma (stab wounds and
      gunshot wounds). However, for blunt trauma, the mortality was significantly
      higher for UW (IW vs UW, 4.3% vs 9.4%, P = 0.001), no different for IW vs OW
      (4.3% vs 3.7%, P = 0.3), and significantly lower for IW vs OB (4.3% vs 2.8%, P = 
      0.04) and for IW vs MO (4.3% vs 1.0%, P = 0.03). After traumatic injuries, it is 
      the underweight patients (BMI &lt;19) and not the obese, that are at a significantly
      higher risk for overall mortality; this difference is especially evident after
      blunt trauma where obesity may actually confer a protective role.
FAU - Treto, Kevin
AU  - Treto K
FAU - Safcsak, Karen
AU  - Safcsak K
FAU - Chesire, David
AU  - Chesire D
FAU - Bhullar, Indermeet S
AU  - Bhullar IS
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Am Surg
JT  - The American surgeon
JID - 0370522
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Body Mass Index
MH  - Female
MH  - Humans
MH  - Injury Severity Score
MH  - Male
MH  - Middle Aged
MH  - Registries
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Trauma Centers
MH  - Wounds and Injuries/*mortality
EDAT- 2017/04/21 06:00
MHDA- 2017/05/02 06:00
CRDT- 2017/04/21 06:00
PST - ppublish
SO  - Am Surg. 2017 Apr 1;83(4):341-347.

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