TY  - JOUR
PY  - 2015//
TI  - Body mass index in blunt trauma patients with hemorrhagic shock: opposite ends of the body mass index spectrum portend poor outcome
JO  - American journal of surgery
A1  - Hwabejire, John O.
A1  - Nembhard, Christine E.
A1  - Obirieze, Augustine C.
A1  - Oyetunji, Tolulope A.
A1  - Tran, Daniel D.
A1  - Fullum, Terrence M.
A1  - Siram, Suryanarayana M.
A1  - Cornwell, Edward E.
A1  - Greene, Wendy R.
SP  - 659
EP  - 665
VL  - 209
IS  - 4
N2  - BACKGROUND: There are controversial data on the relationship between trauma and body mass index. We investigated this relationship in traumatic hemorrhagic shock. <br><br>METHODS: The "Glue Grant" database was analyzed, stratifying patients into underweight, normal weight (NW), overweight, Class I obesity, Class II obesity, and Class III obesity. Predictors of mortality and surgical interventions were statistically determined. <br><br>RESULTS: One thousand nine hundred seventy-six patients were included with no difference in injury severity between groups. Marshall's score was elevated in overweight (5.3 ± 2.7, P =.016), Class I obesity (5.8 ± 2.7, P <.001), Class II obesity (5.9 ± 2.8, P <.001), and Class III obesity (6.3 ± 3.0, P <.001) compared with NW (4.8 ± 2.6). Underweight had higher lactate (4.8 ± 4.2 vs 3.3 ± 2.5, P =.04), were 4 times more likely to die (odds ratio 3.87, confidence interval 2.22 to 6.72), and were more likely to undergo a laparotomy (odds ratio 2.06, confidence interval 1.31 to 3.26) than NW. <br><br>CONCLUSION: Early assessment of body mass index, with active management of complications in each class, may reduce mortality in traumatic hemorrhagic shock.<p />  <p>Language: en</p>
LA  - en
SN  - 0002-9610
UR  - http://dx.doi.org/10.1016/j.amjsurg.2014.12.016
ID  - ref1
ER  -