FORT MYERS, FLA. — Severely obese patients are more likely other patients to develop common complications and to die following trauma, according to a retrospective study of more than 1.3 million patients.
An analysis of National Trauma Data Bank records for more than 1,373,777 trauma patients from 2002 to 2006 found that severely obese patients were 19% more likely to die, compared with other patients, based on crude mortality (odds ratio 1.19). After adjustment, severely obese patients had an even greater risk of death following trauma (OR 1.30), Dr. Neema Kaseje reported at the annual Academic Surgical Congress.
A total of 7,962 trauma patients with a body mass index of more than 40 kg/m
Dr. Kaseje and her colleagues at the Center for Surgery and Public Health at Harvard University in Boston conducted their study to determine if mortality and morbidity following trauma differed between patients who are severely obese and those who are not. The primary outcome was in-hospital mortality. Secondary outcomes included rates of pneumonia, urinary tract infection, wound infection, bacteremia, disseminated fungal infection, and empyema. The researchers adjusted for age, gender, Injury Severity Score (ISS), and insurance status.
Compared with the other patients in the database, severely obese patients were more likely to be older than 49 years (50% vs. 28%, respectively), to be female (53% vs. 34%), to have an ISS greater than 25, and to have health insurance (85% vs. 78%). Severely obese patients also had significantly greater rates of pneumonia (OR 1.73), urinary tract infection (OR 3.25), wound infection (OR 2.16), bacteremia (OR 3.46), and disseminated fungal infection (OR 4.87).
A major limitation of the study is that the data did not include actual BMIs. In the database, patients were classified either as obese (BMI greater than 40 kg/m