Highlights
- •The majority of major trauma patients treated at our regional community are overweight or obese. Understanding the challenges involved in management of these patients is important.
- •No mortality differences were detected in this patient cohort.
- •In obese patients, those with the highest BMI are more likely to require a longer hospital and ICU admission, and suffer from complications including sepsis, acute kidney injury, fluid overload and pneumonia.
Abstract
Purpose
Overweight and obese patients are more prevalent in rural and remote areas and are
of major public health concern in Australia. We aimed to evaluate the mortality and
morbidity of overweight and obese trauma patients in the rural Australian context.
Method
This was a retrospective cohort study on 207 major trauma patients (injury severity
score [ISS] > 12) treated at the Mackay Base Hospital between 2018 and 2021. Data
was extracted from the Mackay Base Hospital trauma database and hospital records.
Outcomes were compared between body mass index (BMI) groups.
Results
There were 164 males (79%) and 43 females (21%). The average BMI was 27.09 (standard
deviation 5.46). 7 patients (3%) were in the underweight category (BMI < 18.5 kg/m2), 70 (34%) were of normal weight (BMI 18.5–24.9 kg/m2), 79 (38%) were overweight (BMI 25–29.9 kg/m2), and 51 (25%) were obese (BMI > 30 kg/m2). The majority of trauma was blunt (n = 203, 98%). Compared to patients with normal BMI, obese patients were significantly
more likely to require intubation, intensive care unit (ICU) admission, and have a
longer ICU stay. There were no significant differences in requirement for surgery,
duration of surgery, hospital length of stay, ventilator time, or mortality (P > 0.05). However, subgroup analysis of the obese patient group showed an increased
rate of complications (sepsis, acute kidney injury, fluid overload and pneumonia),
longer ventilation times, hospital and ICU length of stay with increasing BMI in these
patients.
Conclusion
The majority of trauma presentations in our regional community are in overweight or
obese patients. Overweight and obese patients are more likely to require intubation
and have a longer intensive care unit admission than normal weight counterparts. Amongst
obese patients, those with BMI > 40 (obesity class 3) are at significantly increased
risk of complications.
Keywords
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Article info
Publication history
Published online: January 05, 2023
Accepted:
January 2,
2023
Publication stage
In Press Journal Pre-ProofFootnotes
There are no sources of funding, financial support or industrial affiliations to disclose. The authors declare that they have no conflicts of interest relevant to the manuscript submitted to Injury.
Identification
Copyright
Crown Copyright © 2023 Published by Elsevier Ltd. All rights reserved.
