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Angela L. Neville, MD; Carlos V. R. Brown, MD; Janie Weng, BS; Demetrios Demetriades, MD, PhD; George C. Velmahos, MD, PhD

Arch Surg. 2004;139:983-987.

Hypothesis  Obesity is associated with increased morbidity and mortality in critically injured blunt trauma patients.

Design  Case-control study of all critically injured blunt trauma patients between January 2002 and December 2002.

Setting  Academic level I trauma center at a county referral hospital.

Patients  Two hundred forty-two consecutive patients admitted to the intensive care unit following blunt trauma. Patients were divided into 2 groups by body mass index. The obese group was defined as having a body mass index of 30 kg/m² or higher, and the nonobese group was defined as having a body mass index lower than 30 kg/m².

Main Outcome Measures  Univariate and multivariate analyses were performed to identify risk factors for mortality. Complications and length of stay were also evaluated.

Results  Of the 242 patients, 63 (26%) were obese, and 179 (74%) were nonobese. The obese and nonobese groups were similar with regard to age (mean ± SD, 49 ± 18 years vs 45 ± 22 years), male sex (63% vs 72%), Glasgow Coma Scale score (mean ± SD, 11 ± 5 vs 11 ± 5), and injury severity score (mean ± SD, 21 ± 13 vs 20 ± 14). The obese group had a higher body mass index (mean ± SD, 35 ± 7 vs 24 ± 3; P<.001). Mechanisms of injury and injury patterns were similar between groups. The obese group had a higher incidence of multiple organ failure (13% vs 3%; P = .02) and mortality (32% vs 16%; P = .008). Obesity was an independent predictor of mortality with an adjusted odds ratio of 5.7 (95% confidence interval, 1.9-19.6; P = .003).

Conclusions  Critically injured obese trauma patients have similar demographics and injury patterns as nonobese patients. Obesity is an independent predictor of mortality following severe blunt trauma.

From the Department of Surgery, Division of Trauma and Critical Care, Los Angeles County and University of Southern California Medical Center, Los Angeles.

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