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肥胖对成年创伤患者死亡率的影响。

Impact of Obesity on Mortality in Adult Trauma Patients.

作者信息

Drury Blake, Kocharians Christopher, Dong Fanglong, Tran Louis, Beroukhim Shawhin, Hajjafar Reza, Vara Richard, Wong David, Woodward Brandon, Neeki Michael M

机构信息

Emergency Medicine, Arrowhead Regional Medical Center, Colton, USA.

Medicine, Western University of Health Sciences, Pomona, USA.

出版信息

Cureus. 2021 Feb 15;13(2):e13352. doi: 10.7759/cureus.13352.

Abstract

Introduction Trauma is a major cause of morbidity and mortality amongst all populations in the United States. With the widespread increase of obesity in the United States, studies have been conducted to compare different body mass index (BMI) groups and their clinical outcomes for traumatic injuries. The goal of this study was to retrospectively compare mortality between adult trauma patients with a high BMI to those with a lower BMI as well as investigate whether the mechanism of trauma had an effect on the outcome. Methods This study was a retrospective review of all adult trauma patients presented to the emergency department at Arrowhead Regional Medical Center (ARMC) between January 2014 and October 2019. The outcome was all-cause mortality. Patients were grouped according to BMI and mechanisms of injury, including blunt trauma, low velocity penetrating trauma, and high velocity penetrating trauma. Patients were also stratified by injury severity scores (ISS). Results Among the 9642 patients assessed in this study, majority (88%) of patients sustained blunt trauma. The number of patients among the three different BMI groups was appropriately equal with 34.4% of normal BMI, 34.6% overweight, and 31.1% obese. The overall mortality of all patients studied was 2.6% (n=248). There was no statistically significant difference in mortality among the three different BMI groups for blunt trauma, penetrating trauma, and subgroup analyses stratified by ISS score (ISS<16 or ISS ≥ 16). Conclusion Our study found no statistically significant differences in mortality among the three BMI groups in regard to mortality, even when stratified by ISS, or mechanism of injury, and traumatic velocities.

摘要

引言

创伤是美国所有人群发病和死亡的主要原因。随着美国肥胖症的普遍增加,已开展研究比较不同体重指数(BMI)组及其创伤性损伤的临床结局。本研究的目的是回顾性比较高BMI成年创伤患者与低BMI成年创伤患者的死亡率,并调查创伤机制是否对结局有影响。

方法

本研究是对2014年1月至2019年10月在箭头区域医疗中心(ARMC)急诊科就诊的所有成年创伤患者进行的回顾性分析。结局指标为全因死亡率。患者根据BMI和损伤机制进行分组,包括钝性创伤、低速穿透伤和高速穿透伤。患者还按损伤严重程度评分(ISS)进行分层。

结果

在本研究评估的9642例患者中,大多数(88%)患者为钝性创伤。三个不同BMI组的患者数量大致相等,正常BMI患者占34.4%,超重患者占34.6%,肥胖患者占31.1%。所有研究患者的总死亡率为2.6%(n = 248)。在钝性创伤、穿透伤以及按ISS评分分层(ISS<16或ISS≥16)的亚组分析中,三个不同BMI组之间的死亡率无统计学显著差异。

结论

我们的研究发现,在死亡率方面,三个BMI组之间无统计学显著差异,即使按ISS、损伤机制或创伤速度分层也是如此。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cca8/7968702/1f0ae02928d4/cureus-0013-00000013352-i01.jpg

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