OBJECTIVE: The objective of this study was to characterize relationships between obesity and initial hospital stay, including complications, in patients with multiple system trauma and surgically treated fractures. DESIGN: Prospective, observational. SETTING: Level 1 trauma center. PATIENTS: Three hundred seventy-six patients with an Injury Severity Score greater than 16 and mechanically unstable high-energy fractures of the femur, pelvic ring, acetabulum, or spine requiring stabilization. MAIN OUTCOME MEASUREMENTS: Data for obese (body mass index ≥ 30) versus nonobese patients included presence of pneumonia, deep vein thrombosis, pulmonary embolism, infection, organ failure, and mortality. Days in ICU and hospital, days on ventilator, transfusions, and surgical details were documented. RESULTS: Complications occurred more often in obese patients (38.0% vs. 28.4%, P = 0.03), with more acute renal failure (5.70% vs. 1.38%, P = 0.02) and infection (11.4% vs. 5.50%, P = 0.04). Days in ICU and mechanical ventilation times were longer for obese patients (7.06 vs. 5.25 days, P = 0.05 and 4.92 vs. 2.90 days, P = 0.007, respectively). Mean total hospital stay was also longer for obese patients (12.3 vs. 9.79 days, P = 0.009). No significant differences in rates of mortality, multiple organ failure, or pulmonary complications were noted. Medically stable obese patients were almost twice as likely to experience delayed fracture fixation due to preference of the surgeon and were more likely to experience delay overall (26.0% vs. 16.1%; P = 0.02). Mean time from injury to fixation was 34.9 hours in obese patients versus 23.7 hours in nonobese patients (P = 0.03). CONCLUSIONS: Obesity was noted among 42% of our trauma patients. In obese patients, complications occurred more often and hospital and ICU stays were significantly longer. These increases are likely to be associated with greater hospital costs. Surgeon decision to delay procedures in medically stable obese patients may have contributed to these findings; definitive fixation was more likely to be delayed in obese patients. Further study to optimize the care of patients with increased body mass index may help to improve outcomes and minimize additional treatment expenses.
OBJECTIVE: The objective of this study was to characterize relationships between obesity and initial hospital stay, including complications, in patients with multiple system trauma and surgically treated fractures. DESIGN: Prospective, observational. SETTING: Level 1 trauma center. PATIENTS: Three hundred seventy-six patients with an Injury Severity Score greater than 16 and mechanically unstable high-energy fractures of the femur, pelvic ring, acetabulum, or spine requiring stabilization. MAIN OUTCOME MEASUREMENTS: Data for obese (body mass index ≥ 30) versus nonobese patients included presence of pneumonia, deep vein thrombosis, pulmonary embolism, infection, organ failure, and mortality. Days in ICU and hospital, days on ventilator, transfusions, and surgical details were documented. RESULTS: Complications occurred more often in obesepatients (38.0% vs. 28.4%, P = 0.03), with more acute renal failure (5.70% vs. 1.38%, P = 0.02) and infection (11.4% vs. 5.50%, P = 0.04). Days in ICU and mechanical ventilation times were longer for obesepatients (7.06 vs. 5.25 days, P = 0.05 and 4.92 vs. 2.90 days, P = 0.007, respectively). Mean total hospital stay was also longer for obesepatients (12.3 vs. 9.79 days, P = 0.009). No significant differences in rates of mortality, multiple organ failure, or pulmonary complications were noted. Medically stable obesepatients were almost twice as likely to experience delayed fracture fixation due to preference of the surgeon and were more likely to experience delay overall (26.0% vs. 16.1%; P = 0.02). Mean time from injury to fixation was 34.9 hours in obesepatients versus 23.7 hours in nonobese patients (P = 0.03). CONCLUSIONS:Obesity was noted among 42% of our traumapatients. In obesepatients, complications occurred more often and hospital and ICU stays were significantly longer. These increases are likely to be associated with greater hospital costs. Surgeon decision to delay procedures in medically stable obesepatients may have contributed to these findings; definitive fixation was more likely to be delayed in obesepatients. Further study to optimize the care of patients with increased body mass index may help to improve outcomes and minimize additional treatment expenses.
Authors: Shubing Cai; Sijiu Wang; Dana B Mukamel; Thomas Caprio; Helena Temkin-Greener Journal: J Am Med Dir Assoc Date: 2019-03-08 Impact factor: 4.669
Authors: Balázs Poros; Thomas Irlbeck; Philipp Probst; Alexander Volkmann; Philipp Paprottka; Wolfgang Böcker; Michael Irlbeck; Thomas Weig Journal: Eur J Trauma Emerg Surg Date: 2019-11-19 Impact factor: 3.693
Authors: Raveesh D Richard; Greg E Gaski; Hassan Farooq; Daniel J Wagner; Todd O McKinley; Roman M Natoli Journal: J Clin Orthop Trauma Date: 2022-06-25
Authors: Jayshil J Patel; Martin D Rosenthal; Keith R Miller; Panna Codner; Laszlo Kiraly; Robert G Martindale Journal: Curr Gastroenterol Rep Date: 2016-09