TY - JOUR
T1 - Body Mass Index and Mortality in Blunt Trauma
T2 - The Right BMI can be Protective
AU - Choi, James
AU - Smiley, Abbas
AU - Latifi, Rifat
AU - Gogna, Shekhar
AU - Prabhakaran, Kartik
AU - Con, Jorge
AU - Anderson, Patrice
AU - Policastro, Anthony
AU - Beydoun, Malk
AU - Rhee, Peter
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/12
Y1 - 2020/12
N2 - Background: There are limited studies examining the role of BMI on mortality in the trauma population. The aim of this study was to analyze whether the “obesity paradox” exists in non-elderly patients with blunt trauma. Methods: A retrospective study was performed on the Trauma Quality Improvement Program (TQIP) database for 2016. All non-elderly patients aged 18–64, with blunt traumatic injuries were identified. A generalized additive model (GAM) was built to assess the association of mortality and BMI adjusted for age, gender, race, and injury severity score (ISS). Results: 28,475 patients (mean age = 42.5, SD = 14.3) were identified. 20,328 (71.4%) were male. Age (p < 0.0001), gender (p < 0.0001), and ISS (p < 0.0001) had significant associations with mortality. After GAM, BMI showed a significant U-shaped association with mortality (EDF = 3.2, p = 0.003). A BMI range of 31.5 ± 0.9 kg/m2 was associated with the lowest mortality. Conclusion: High BMI can be a protective factor in mortality within non-elderly patients with blunt trauma. However, underweight or morbid obesity suggest a higher risk of mortality.
AB - Background: There are limited studies examining the role of BMI on mortality in the trauma population. The aim of this study was to analyze whether the “obesity paradox” exists in non-elderly patients with blunt trauma. Methods: A retrospective study was performed on the Trauma Quality Improvement Program (TQIP) database for 2016. All non-elderly patients aged 18–64, with blunt traumatic injuries were identified. A generalized additive model (GAM) was built to assess the association of mortality and BMI adjusted for age, gender, race, and injury severity score (ISS). Results: 28,475 patients (mean age = 42.5, SD = 14.3) were identified. 20,328 (71.4%) were male. Age (p < 0.0001), gender (p < 0.0001), and ISS (p < 0.0001) had significant associations with mortality. After GAM, BMI showed a significant U-shaped association with mortality (EDF = 3.2, p = 0.003). A BMI range of 31.5 ± 0.9 kg/m2 was associated with the lowest mortality. Conclusion: High BMI can be a protective factor in mortality within non-elderly patients with blunt trauma. However, underweight or morbid obesity suggest a higher risk of mortality.
KW - Blunt trauma
KW - Generalized additive model
KW - Obesity
KW - Obesity paradox
KW - Retrospective
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U2 - 10.1016/j.amjsurg.2020.10.017
DO - 10.1016/j.amjsurg.2020.10.017
M3 - Article
C2 - 33109335
AN - SCOPUS:85093924682
VL - 220
SP - 1475
EP - 1479
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
IS - 6
ER -