%0 Journal Article %T Obese Patients Show a Depressed Cytokine Profile Following Severe Blunt Injury %J Shock %D 2012 %A Winfield, Robert D. %A Delano, Matthew J. %A Cuenca, Alex G. %A Cendan, Juan C. %A Lottenberg, Lawrence L. %A Efron, Philip A. %A Maier, Ronald V. %A Remick, Daniel G. %A Moldawer, Lyle L. %A Cuschieri, Joseph %V 37 %N 3 %P 253-256 %X OBJECTIVE: We hypothesized that severely injured obese patients would display increased concentrations of pro-inflammatory cytokines when compared to patients of normal body mass index (BMI), and that this would be associated with multiple organ failure (MOF). DESIGN: Retrospective review of prospectively collected data in the "Inflammation and the Host Response to Injury" trauma-related database. SETTING: Data was collected prospectively from United States Level I trauma centers PATIENTS: Severely injured adult blunt trauma patients MEASUREMENTS: Cytokine concentrations obtained within 12 hrs of injury and on days one and four were compared between subjects on the basis of BMI (Normal, 18.5-24.9 kg/m and Obese, ≥ 30 kg/m). Demographic measures, injury severity, cytokine concentrations, and outcome measures were compared between groups. MAIN RESULTS: 74 adult blunt trauma victims were evaluated. Relative to patients of normal BMI (n=34), obese patients (n=40) demonstrated an overall depressed cytokine response to severe injury, with significantly lower concentrations of several cytokines. Obese patients showed greater incidences of nosocomial infection (60 vs. 45%, NS) and MOF (63% vs. 44%, NS) and a later onset of maximum MOF score (5 days vs. 3, pπ.04) when compared to those of normal BMI. CONCLUSIONS: Despite prior reports suggesting a pro-inflammatory cytokine profile in obese individuals, obese patients sustaining severe injury show a depressed early cytokine response when compared to patients of normal BMI. This may confer increased susceptibility to nosocomial infection and later MOF. Further study of immune dysfunction in the post-injury obese patient should assess the possibility of early immune suppression.

Language: en

%G en %I Lippincott Williams and Wilkins %@ 1073-2322 %U http://dx.doi.org/10.1097/SHK.0b013e3182449c0e