| Title |
Obese trauma patients are at increased risk of early hypovolemic shock: a retrospective cohort analysis of 1,084 severely injured patients
|
|---|---|
| Published in |
Critical Care, May 2012
|
| DOI | 10.1186/cc11334 |
| Pubmed ID | |
| Authors |
Jana Nelson, Adrian T Billeter, Burkhardt Seifert, Valentin Neuhaus, Otmar Trentz, Christoph K Hofer, Matthias Turina |
| Abstract |
ABSTRACT: INTRODUCTION: Morbid obesity and its consequences are considered risk factors for adverse outcome in trauma, although the pathophysiologic mechanisms are incompletely understood. The aim of this study was to compare initial resuscitation, treatment, and short-term outcome of severely injured patients by body mass index (BMI). METHODS: A total of 1,084 severely injured patients with an injury severity score of 16 or greater were enrolled between 1996 and 2009 and grouped according to BMI. Their course of treatment and in-hospital outcome were analyzed by univariate and multivariate comparison. RESULTS: Of these patients, 603 (55.6%) were of normal weight with a BMI between 18.5 and 24.9, 361 (33.3%) had BMI values between 25 and 29.9, and 90 patients (8.3%) were obese (BMI ≥ 30). Thirty patients (2.8%) had BMI levels below 18.5. All groups were comparable with respect to injury severity, initial resuscitation, and time to ICU admission. There was a tendency towards higher mortality in obese patients (mortality 24.4%) and also overweight patients (mortality 18.8%) when compared with patients with a normal BMI (mortality 16.6%). Obese patients showed the highest mortality on day 0 (8.9% vs. 2.8% in the normal-weight group, P = 0.023), mostly due to persistent shock (6.7%). When corrected for BMI, obese patients are provided significantly lower volumes of intravenous fluids during the initial resuscitation period. CONCLUSION: In contrast to the mostly American literature, only a low percentage of trauma patients at a European trauma center are obese. These patients are at risk of higher mortality from persistent hemorrhagic shock in the initial phase after trauma, which may potentially be related to relative hypovolemia during the resuscitation period. In the later course of treatment, no significant differences exist with respect to specific complications, hospital stay, or in-hospital mortality. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 50% |
| Unknown | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 62 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Brazil | 2 | 3% |
| France | 1 | 2% |
| Austria | 1 | 2% |
| Mexico | 1 | 2% |
| Belgium | 1 | 2% |
| United States | 1 | 2% |
| Unknown | 55 | 89% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 9 | 15% |
| Other | 8 | 13% |
| Researcher | 8 | 13% |
| Student > Postgraduate | 6 | 10% |
| Student > Ph. D. Student | 6 | 10% |
| Other | 11 | 18% |
| Unknown | 14 | 23% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 35 | 56% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 3% |
| Biochemistry, Genetics and Molecular Biology | 2 | 3% |
| Engineering | 2 | 3% |
| Nursing and Health Professions | 2 | 3% |
| Other | 3 | 5% |
| Unknown | 16 | 26% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 November 2021.
All research outputs
#16,046,765
of 25,371,288 outputs
Outputs from Critical Care
#5,210
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Outputs of similar age
#107,206
of 176,039 outputs
Outputs of similar age from Critical Care
#52
of 95 outputs
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