Impact of Obesity in the Critically Ill Trauma Patient: A Prospective Study - 09/08/11
⁎ 
, Manjari Joshi, MD †, Kelly Bochicchio, RN, BSN †, Shelly Nehman, MS, RD, CNSD ‡, J. Kathleen Tracy, PhD §, Thomas M. Scalea, MD, FACS Department of Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD Correspondence address: Grant V Bochicchio, MD, MPH, Department of Surgery, R Adams Cowley Shock Trauma Center, 22 South Greene St, Baltimore, MD 21201.Résumé |
Background |
Obesity has risen at an epidemic rate over the past 20 years in the US. To our knowledge, there is an absence of data evaluating the impact of obesity in the critically ill trauma patient.
Methods |
Prospective data were collected on 1,167 patients admitted to the ICU over a 2-year period. Obesity was defined as a body mass index (calculated as weight [kg]/height [m2]) of 30 or higher. Outcomes analyzed included infection rate, hospital and ICU length of stay, and mortality. Multiple logistic regression was used to evaluate outcomes between obese and nonobese patients for infection (infection versus noninfection) and mortality (deceased versus not deceased). Continuous outcomes such as hospital and ICU lengths of stay were evaluated using multiple linear regression analyses.
Results |
Sixty-two of 1,167 (5.3%) patients were obese. The majority (71%) of injuries in the study cohort were blunt. Although the majority of patients were men (76%), women (10% versus 4%) were more likely to be obese (p < 0.001). Obese patients had a more than twofold increase in risk of acquiring a bloodstream, urinary tract, or respiratory infection, or being admitted to the ICU (p < 0.001), after statistically controlling for age and Injury Severity Score. When controlling for diabetes, gender, obesity, age, COPD, and Injury Severity Score, obese patients were 7.1 times (95% CI, 2.06–8.9) more likely to die in the hospital.
Conclusions |
Obesity is associated with a substantial increase in morbidity and mortality in the critically ill trauma patient. Future studies are warranted in both the prevention of infection and intensive care management of the obese trauma patient.
Le texte complet de cet article est disponible en PDF.Plan
| Competing Interests Declared: None. |
Vol 203 - N° 4
P. 533-538 - octobre 2006 Retour au numéro
Article précédent
- Bowel Resection at the Time of Primary Debulking for Epithelial Ovarian Carcinoma: Outcomes in Patients Treated with Platinum and Taxane-Based Chemotherapy
- Jacob M. Estes, Charles A. Leath, J. Michael Straughn, Rodney P. Rocconi, Tyler O. Kirby, Warner K. Huh, Mack N. Barnes
- Obesity Increases Risk of Organ Failure after Severe Trauma
- David J. Ciesla, Ernest E. Moore, Jeffery L. Johnson, Jon M. Burch, C. Clay Cothren, Angela Sauaia
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?