The impact of body mass index on the physiology of patients with polytrauma

Purpose: Obesity is a growing problem in industrial nations. The aim was to test the hypothesis that overweight patients face early physiologic impairment. Methods: A total of 651 patients were included in this retrospective study, with an injury severity score greater than 16 and 16 years or older. The sample was subdivided into 3 groups: body mass index (BMI) less than 25 kg/m(2), BMI of 25 to 30 kg/m(2), and BMI greater than 30 kg/m(2). Physiologic scores-Murray, Goris, Marshall and Sequential Organ Failure Assessment scores-were analyzed at admission and at the day of their maximum. Analysis of variance and chi(2) tests were used, and the significance level was set at P < .05. Results: All 4 scores showed significant differences at their maxima according to the 3 BMI groups, respectively: Murray score (P < .001), Goris score (P < .05), Marshall score (P < .001), and Sequential Organ Failure Assessment score (P < .05). The injury severity score values of the 3 groups at admission were 27.6 +/- 12.0, 29.6 +/- 13.2, and 25.3 +/- 9.2, respectively (P < .05). The overall mortality rates in the 3 groups were 15.1%, 21.0%, and 20%, respectively (P < .001). Conclusions: Anticipating BMI-specific critical trauma problems will become mandatory for effective polytrauma treatment in industrialized nations given their increasing prevalence of obesity. (C) 2012 Elsevier Inc. All rights reserved.