Christmas A Britton, Reynolds Jennifer, Wilson Ashley K, Franklin Glen A, Miller Frank B, Richardson J David, Rodriguez Jorge L
Department of Surgery, University of Louisville, Louisville, Kentucky, USA.
Am Surg. 2007 Nov;73(11):1122-5.
Twenty-six per cent of adults in the Unites States are obese and trauma remains a major cause of death. We assessed the impact of morbid obesity on mortality in patients with blunt trauma. We reviewed the records of patients with a body mass index 40 kg/m2 or greater injured by blunt trauma from 1993 to 2003 and compared them with a 4:1 control population with a normal body mass index and matched for sex and constellation of injuries. For comparison, patients were categorized by Injury Severity Score 9 or less or Injury Severity Score 10 or greater. Student t test and chi2 were used for statistical analysis. P < 0.05 was considered significant. One hundred seven morbidly obese patients were identified and compared with 458 control subjects with a normal body mass index and matched for sex and constellation of injuries. Although the morbidly obese patients were found to be significantly younger, those who incurred multiorgan injury experienced a significantly longer hospital length of stay and displayed a greater than fourfold increase in mortality when compared with the control subjects. Furthermore, the number of morbidly obese patients admitted over the 10-year period significantly increased by fourfold (0.4% to 1.5%). Over the last decade, there has been a significant increase in morbidly obese patients cared for in our trauma center. Although these patients were significantly younger with a similar Glasgow Coma Score as that of the control population, morbid obesity significantly increased mortality when the injury from blunt trauma transitioned from a single to a multiorgan injury.
美国26%的成年人患有肥胖症，创伤仍然是主要死因。我们评估了病态肥胖对钝性创伤患者死亡率的影响。我们回顾了1993年至2003年体重指数40kg/m²及以上的钝性创伤患者的记录，并将他们与体重指数正常、性别和损伤情况匹配的4:1对照组人群进行比较。为了进行比较，患者按损伤严重度评分9分及以下或损伤严重度评分10分及以上进行分类。采用学生t检验和卡方检验进行统计分析。P<0.05被认为具有统计学意义。共识别出107例病态肥胖患者，并与458例体重指数正常、性别和损伤情况匹配的对照者进行比较。尽管发现病态肥胖患者明显更年轻，但与对照者相比，发生多器官损伤的患者住院时间明显更长，死亡率增加了四倍多。此外，10年间收治的病态肥胖患者数量显著增加了四倍（从0.4%增至1.5%）。在过去十年中，我们创伤中心收治的病态肥胖患者显著增加。尽管这些患者明显更年轻，格拉斯哥昏迷评分与对照人群相似，但当钝性创伤从单器官损伤转变为多器官损伤时，病态肥胖显著增加了死亡率。
