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Correspondence and Brief Communications |

Effect of Obesity on Mortality in Severely Injured Blunt Trauma Patients Remains Unclear

Joe G. Zein, MD; Roxie M. Albrecht, MD, FACS; Maroun M. Tawk, MD; Gary T. Kinasewitz, MD
Arch Surg. 2005;140(11):1130-1131. doi:10.1001/archsurg.140.11.1130-c.
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The recent report by Neville et al1 concluded that obesity (body mass index ≥30 kg/m2) was an independent predictor of mortality in blunt trauma patients requiring intensive care unit (ICU) care.

We reviewed 304 patients (aged ≥17 years) admitted to the OU Medical Center level 1 trauma ICU from January 1 through July 30, 2004, for greater than 48 hours.2 The majority were male (75%), suffered blunt trauma (86%), and 33% were obese. Overall mortality (11.3% vs 12.1%, P = .83) and mortality in the obese and nonobese suffering blunt injury (11.6% vs 10.7%, P = .8) were similar. Obese patients with a lower degree of trauma (level 2) or a Trauma and Injury Severity Score of greater than 0.8 had a nonsignificant increase in mortality, 8% vs 3% compared with nonobese patients. Obese patients had a longer duration of mechanical ventilation (mean ± SD, 5.3 ± 0.8 vs 3.2 ± 0.7 days, P = .06) and ICU length of stay (9.9 ± 0.9 vs 6.3 ± 0.8 days, P = .002). Obese patients also had increased plasma creatinine (1.26 ± 0.07 vs 1.02 ± 0.06 mg/dL; P = .03) and glucose levels (168 ± 6 vs 141 ± 5 mg/dL; P = .002), and a lower PaO2 /FiO2 ratio (214 ± 21 vs 306 ± 19; P = .007).

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