The impact of BMI on polytrauma outcome

• Published in: Injury Vol. 43; no. 2; pp. 184 - 188
• Main Authors: Hoffmann, Michael, Lefering, Rolf, Gruber-Rathmann, Michaela, Rueger, Johannes Maria, Lehmann, Wolfgang
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.02.2012
• Subjects: Adult; Age; BMI; Body Mass Index; Cohort Studies; Female; Follow-Up Studies; Hospital Mortality - trends; Humans; Injuries; Injury Severity Score; Length of Stay; Logistic Models; Male; Middle Aged; Multiple Trauma - mortality; Multiple Trauma - physiopathology; Multiple Trauma - surgery; Multivariate Analysis; Obesity; Obesity - complications; Obesity - mortality; Obesity - physiopathology; Odds Ratio; Orthopedics; Outcome; Polytrauma; Registry; Retrospective Studies; Risk Factors; Thinness - complications; Thinness - mortality; Thinness - physiopathology; Trauma; Treatment Outcome; Underweight; Wound Healing; Obesity; Polytrauma; Outcome; Underweight; Registry; Trauma; Injuries; BMI
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2011.05.029

Abstract Background Varying results have been reported concerning the effect of body mass index (BMI) on polytrauma outcome. Although most studies focus on obesity and its associated preexisting medical diseases as a predictor for increased mortality rates, there is evidence that polytrauma patients with underweight also face an inferior outcome. Methods Records of 5766 trauma patients (minimum 18 years of age, Injury Severity Score ≥ 16, treated from 2004 to 2008) documented in the Trauma Registry of the German Society for Trauma Surgery were subclassified into 4 BMI groups and analysed to assess the impact of BMI on polytrauma outcome. Results Underweight (BMI Group I) as well as obesity (BMI Group IV) in polytraumatized patients are associated with significantly increased mortality by multivariate logistic regression analysis with hospital mortality as the target variable (adjusted odds ratio for BMI Group I, 2.1 (95% CI 1.2–3.8, p = 0.015); for BMI Group IV, 1.6 (95% CI 1.1–2.3, p = 0.009)). Simple overweight (BMI Group III) does not qualify as a predictor for increased mortality (odds ratio 1.0; 95% CI 0.8–1.3). Conclusions There is a significant correlation between obesity, underweight, and increased mortality in polytraumatized patients. Efforts to promote optimal body weight may reduce not only the risk of chronic diseases but also the risk of polytrauma mortality amongst obese and underweight individuals.