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肥胖与钝性与穿透性机制在创伤剖腹手术患者中的相关性研究。

Obesity and Associated Outcomes for Blunt vs Penetrating Mechanism in Trauma Laparotomy Patients.

机构信息

Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA.

出版信息

Am Surg. 2024 Aug;90(8):2120-2123. doi: 10.1177/00031348241241725. Epub 2024 Apr 2.

Abstract

Obesity in trauma patients is an established risk factor contributing to postoperative complications, but the relationship between body mass index (BMI) and trauma patient outcomes is not well-defined, especially when stratified by mechanism of injury. We surveyed the trauma laparotomy registry at an academic level 1 trauma center over a 3-year period to identify mortality, injury severity score, and hospital length of stay (hLOS) outcome measures across BMI classes, with further stratification by mechanism of injury: blunt vs penetrating trauma. A total of 442 patients were included with mean age 44.6 (SD = 18.7) and mean BMI 28.55 (SD = 7.37). These were subdivided into blunt trauma (n = 313) and penetrating trauma (n = 129). Within the blunt trauma subgroup, the hLOS among patients who survived hospitalization significantly increased 9% for each successive BMI class ( = .022, 95% CI = 1.29-17.5). We conclude that successive increase in BMI class is associated with longer hospital stay for blunt trauma patient survivors requiring laparotomy, though additional analysis is needed to establish this relationship to other outcome measures and among penetrating trauma patients.

摘要

创伤患者肥胖是术后并发症的既定危险因素,但体重指数(BMI)与创伤患者结局之间的关系尚未明确,尤其是按损伤机制分层时。我们调查了 3 年内一家学术性一级创伤中心的创伤剖腹手术登记处,以确定 BMI 分级的死亡率、损伤严重程度评分和住院时间(hLOS)结局指标,并进一步按损伤机制分层:钝性与穿透性损伤。共纳入 442 例患者,平均年龄 44.6(SD = 18.7),平均 BMI 为 28.55(SD = 7.37)。这些患者分为钝性创伤(n = 313)和穿透性创伤(n = 129)。在钝性创伤亚组中,存活住院患者的 hLOS 随着 BMI 级别的连续增加而显著增加了 9%(=.022,95%CI = 1.29-17.5)。我们得出结论,对于需要剖腹手术的钝性创伤患者幸存者,BMI 级别的连续增加与住院时间延长相关,但需要进一步分析以确定这种关系是否适用于其他结局指标以及穿透性创伤患者。

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