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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 1/2014

01-02-2014 | Original Article

The impact of body mass index on treatment outcomes among traumatic brain injury patients in intensive care units

Authors: S. Y. Chabok, H. Yazdanshenas, A. F. Naeeni, A. Ziabakhsh, S. S. Bidar, A. Reihanian, S. Bazargan-Hejazi

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2014

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Abstract

Purpose

Obesity is a risk factor in treatment outcomes of critically ill patients. This study was conducted to determine the impact of obesity on the likelihood of recovery from traumatic brain injury (TBI) in intensive care unit (ICU) patients.

Methods

We carried out a prospective study on 115 head injury patients who were admitted to the ICU of Poursina Hospital, Rasht, in the one-year period between July 2006 and June 2007. Obese patients (body mass index [BMI] ≥ 30 kg/m2) were compared with non-obese patients (BMI < 30 kg/m2). Demographic information, acute physiology and chronic health evaluation scores, Injury Severity Scores (ISS), Glasgow Coma Scale scores, and ICU mortality incidences were recorded.

Results

Obese patients had significantly higher ICU mortality rates compared to non-obese patients (p = 0.02). Furthermore, we observed a trend towards a higher ICU mortality rate in obese patients with ISS > 25 (p = 0.04). Moreover, obesity was associated with prolonged mechanical ventilation, ICU length of stay (ILOS), and hospital length of stay (HLOS) (p < 0.001).

Conclusions

Obesity was associated with increased ICU mortality and prolonged dependency on mechanical ventilation, ILOS, and HLOS in patients with TBI. However, further prospective studies with larger sample sizes are needed to substantiate these findings.
Literature
1.
2.
Margot S, Carroll M, Ogden Cynthia L. Adult obesity prevalence in Canada and the United States. In: NCHS Data Brief 2011. Atlanta: Centers for Disease Control and Prevention; 2011.
3.
Frezza EE, Chiriva-Internati M. Venous thromboembolism in morbid obesity and trauma. A review of literature. Minerva Chir. 2005;60(5):391–9.PubMed
4.
Kopelman PG. Obesity as a medical problem. Nature. 2000;404(6778):635–43.PubMed
5.
6.
Marik PE. The paradoxical effect of obesity on outcome in critically ill patients. Crit Care Med. 2006;34(4):1251–3.PubMedCrossRef
7.
Evans DC, Stawicki SP, Davido HT, Eiferman D. Obesity in trauma patients: correlations of body mass index with outcomes, injury patterns, and complications. Am Surg. 2011;77(8):1003–8.
8.
Bochicchio GV, Joshi M, Bochicchio K, Nehman S, Tracy JK, Scalea TM. Impact of obesity in the critically ill trauma patient: a prospective study. J Am Coll Surg. 2006;203(4):533–8.
9.
Neville AL, Brown CV, Weng J, Demetriades D, Velmahos GC. Obesity is an independent risk factor of mortality in severely injured blunt trauma patients. Arch Surg. 2004;139(9):983–7.
10.
Livingston DH, Lavery RF, N’Kanza A, Anjaria D, Sifri ZC, Mohr AM, et al. Obesity does not increase morbidity and mortality after laparotomy for trauma. Am Surg. 2013;79(3):247–52.
11.
Liu T, Chen JJ, Bai XJ, Zheng GS, Gao W. The effect of obesity on outcomes in trauma patients: a meta-analysis. Injury, 2012.
12.
Newell MA, Bard MR, Goettler CE, Toschlog EA, Schenarts PJ, Sagraves SG, et al. Body mass index and outcomes in critically injured blunt trauma patients: weighing the impact. J Am Coll Surg. 2007;204(5):1056–61.
13.
Brown CV, Rhee P, Neville AL, Sangthong B, Salim A, Demetriades D. Obesity and traumatic brain injury. J Trauma. 2006;61(3):572–6.
14.
Bercault N, Boulain T, Kuteifan K, Wolf M, Runge I, Fleury JC. Obesity-related excess mortality rate in an adult intensive care unit: a risk-adjusted matched cohort study. Crit Care Med. 2004;32(4):998–1003.
15.
Goulenok C, Monchi M, Chiche JD, Mira JP, Dhainaut JF, Cariou A. Influence of overweight on ICU mortality: a prospective study. Chest. 2004;125(4):1441–5.
16.
Byrnes MC, McDaniel MD, Moore MB, Helmer SD, Smith RS. The effect of obesity on outcomes among injured patients. J Trauma. 2005;58(2):232–7.
17.
El-Solh A, Sikka P, Bozkanat E, Jaafar W, Davies J. Morbid obesity in the medical ICU. Chest. 2001;120(6):1989–97.
18.
O’Brien JM Jr, Phillips GS, Ali NA, Lucarelli M, Marsh CB, Lemeshow S. Body mass index is independently associated with hospital mortality in mechanically ventilated adults with acute lung injury. Crit Care Med. 2006;34(3):738–44.
19.
Tremblay A, Bandi V. Impact of body mass index on outcomes following critical care. Chest. 2003;123(4):1202–7.PubMedCrossRef
20.
Garrouste-Orgeas M, Troche G, Azoulay E, Caubel A, de Lassence A, Cheval C, et al. Body mass index. An additional prognostic factor in ICU patients. Intensive Care Med. 2004;30(3):437–43.
21.
Duane TM, Dechert T, Aboutanos MB, Malhotra AK, Ivatury RR. Obesity and outcomes after blunt trauma. J Trauma. 2006;61(5):1218–21.
22.
Ciesla DJ, Moore EE, Johnson JL, Burch JM, Cothren CC, Sauaia A. Obesity increases risk of organ failure after severe trauma. J Am Coll Surg. 2006;203(4):539–45.
23.
Anzueto A, Frutos-Vivar F, Esteban A, Bensalami N, Marks D, Raymondos K, et al. Influence of body mass index on outcome of the mechanically ventilated patients. Thorax. 2011;66(1):66–73.
24.
Akinnusi ME, Pineda LA, El Solh AA. Effect of obesity on intensive care morbidity and mortality: a meta-analysis. Crit Care Med. 2008;36(1):151–8.PubMedCrossRef
25.
Alban RF, Lyass S, Margulies DR, Shabot MM. Obesity does not affect mortality after trauma. Am Surg. 2006;72(10):966–9.
26.
Zimmerman DW. A note on preliminary tests of equality of variances. Br J Math Stat Psychol. 2004;57(1):173–81.PubMedCrossRef
27.
Choban PS, Weireter LJ Jr, Maynes C. Obesity and increased mortality in blunt trauma. J Trauma. 1991;31(9):1253–7.PubMedCrossRef
28.
Sifri ZC, Kim H, Lavery R, Mohr A, Livingston DH. The impact of obesity on the outcome of emergency intubation in trauma patients. J Trauma. 2008;65(2):396–400.
29.
Sampalis JS, Nathanson R, Vaillancourt J, Nikolis A, Liberman M, Angelopoulos J, et al. Assessment of mortality in older trauma patients sustaining injuries from falls or motor vehicle collisions treated in regional level I trauma centers. Ann Surg. 2009;249(3):488–95.
30.
Sharp JT, Henry JP, Sweany SK, Meadows WR, Pietras RJ. The total work of breathing in normal and obese men. J Clin Invest. 1964;43:728–39.
31.
Pelosi P, Croci M, Ravagnan I, Vicardi P, Gattinoni L. Total respiratory system, lung, and chest wall mechanics in sedated-paralyzed postoperative morbidly obese patients. Chest. 1996;109(1):144–51.
32.
Frat JP, Gissot V, Ragot S, Desachy A, Runge I, Lebert C, et al. Impact of obesity in mechanically ventilated patients: a prospective study. Intensive Care Med. 2008;34(11):1991–8.
33.
Ray CS, Sue DY, Bray G, Hansen JE, Wasserman K. Effects of obesity on respiratory function. Am Rev Respir Dis. 1983;128(3):501–6.
34.
Thomas PS, Cowen ER, Hulands G, Milledge JS. Respiratory function in the morbidly obese before and after weight loss. Thorax. 1989;44(5):382–6.
35.
Varon J, Marik P. Management of the obese critically ill patient. Crit Care Clin. 2001;17(1):187–200.PubMedCrossRef
36.
Lown DJ, Knott J, Rechnitzer T, Maclsaac C. Predicting short-term and long-term mortality in elderly emergency patients admitted for intensive care. Crit Care Resusc. 2013;15(1):49–55.
37.
Zali AR, Seddighi AS, Seddighi A, Ashrafi F. Comparison of the acute physiology and chronic health evaluation score (APACHE) II with GCS in predicting hospital mortality of neurosurgical intensive care unit patients. Glob J Health Sci. 2012;4(3):179–84.
38.
Stocchetti N, Paterno R, Citerio G, Beretta L, Colombo A. Traumatic brain injury in an aging population. J Neurotrauma. 2012;29(6):1119–25.
39.
Udekwu P, Kromhout-Schiro S, Vaslef S, Baker C, Oller D. Glasgow Coma Scale score, mortality, and functional outcome in head-injured patients. J Trauma. 2004;56(5):1084–9.
40.
Farshchian N, Farshchian F, Rezaei M. Correlation between Glasgow coma scale and brain CT-scan findings in traumatic patients. J Inj Violence Res. 2012;4:44.
41.
Shakeri M, Meshkini A, Shokouhi G, Asghari M, Salehpoor F, Mahdkhah A, et al. S100B protein as abiomarker for prediction of brain death following head trauma. J Inj Violence Res. 2012;4:11.
42.
Teoh LS, Gowardman JR, Larsen PD, Green R, Galletly DC. Glasgow Coma Scale: variation in mortality among permutations of specific total scores. Intensive Care Med. 2000;26(2):157–61.
43.
Landi F, Onder G, Gambassi G, Pedone C, Carbonin P, Bernabei R. Body mass index and mortality among hospitalized patients. Arch Intern Med. 2000;160(17):2641–4.
Metadata
Title
The impact of body mass index on treatment outcomes among traumatic brain injury patients in intensive care units
Authors
S. Y. Chabok
H. Yazdanshenas
A. F. Naeeni
A. Ziabakhsh
S. S. Bidar
A. Reihanian
S. Bazargan-Hejazi
Publication date
01-02-2014
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 1/2014
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-013-0314-2

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