Top

European Journal of Trauma and Emergency Surgery

Published in:

01-12-2015 | Original Article

The impact of body mass index on severity, patterns and outcomes after traumatic brain injuries caused by low level falls

Authors: M. Majdan, A. Brazinova, I. Wilbacher, M. Rusnak, W. Mauritz

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2015

Abstract

Purpose

Low level falls are a common cause of traumatic brain injuries (TBI) and are associated with significant mortality and disability. The aim of this study was to analyse whether BMI, height and weight of patients were related to severity, patterns and outcomes of TBI caused by low level falls.

Methods

Data on patients with TBI where cause of injury was a low level fall (fall < 3 m) with known body mass index (BMI) (N = 683) were analysed. Patients were categorized into underweight, normal, pre-obese and obese based on BMI and demographic characteristics, injury severity, patterns and outcomes were compared. In addition, physiological status, comorbidities and length of hospitalization were analysed in a subset of patients where this information was available.

Results

The median BMI was 25.6. About 1/10 of patients were obese. The mean age and proportion of male sex of patients was increasing with increasing BMI. The patients in all BMI groups were of similar injury severity and neurological status. There was also no difference in mortality and functional outcome based on patient’s BMI. Obese and pre-obese patients required longer stay at ICU and in hospital.

Conclusion

We found no associations between BMI and severity or outcome of TBI caused by low level falls. More detailed data and further studies are needed to fully elucidate these complex relationships.

Toevs CC. Trauma in obese patients. Crit Care Clin. 2010;26(4):689–93. doi:10.1016/j.ccc.2010.06.010.CrossRefPubMed

Newell MA, Bard, 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. doi:10.1016/j.jamcollsurg.2006.12.042 (Discussion 62–4).CrossRefPubMed

Osborne Z, Rowitz B, Moore H, Oliphant U, Butler J, Olson M, et al. Obesity in trauma: outcomes and disposition trends. Am J Surg. 2014;207(3):387–92. doi:10.1016/j.amjsurg.2013.10.013.CrossRefPubMed

Maas AI, Stocchetti N, Bullock R. Moderate and severe traumatic brain injury in adults. Lancet Neurol. 2008;7(8):728–41. doi:10.1016/S1474-4422(08)70164-9.CrossRefPubMed

Brown CV, Neville AL, Rhee P, Salim A, Velmahos GC, Demetriades D. The impact of obesity on the outcomes of 1,153 critically injured blunt trauma patients. J Trauma. 2005;59(5):1048–51 (Discussion 51).CrossRefPubMed

Tagliaferri F, Compagnone C, Yoganandan N, Gennarelli TA. Traumatic brain injury after frontal crashes: relationship with body mass index. J Trauma. 2009;66(3):727–9. doi:10.1097/TA.0b013e31815edefd.CrossRefPubMed

Majdan M, Mauritz W, Brazinova A, Rusnak M, Leitgeb J, Janciak I, et al. Severity and outcome of traumatic brain injuries (TBI) with different causes of injury. Brain Inj [BI]. 2011;25(9):797–805. doi:10.3109/02699052.2011.581642.CrossRef

Mauritz W, Brazinova A, Majdan M, Leitgeb J. Epidemiology of traumatic brain injury in Austria. Wien Klin Wochenschr. 2014;126(1–2):42–52. doi:10.1007/s00508-013-0456-6.PubMedCentralCrossRefPubMed

Roozenbeek B, Maas AI, Menon DK. Changing patterns in the epidemiology of traumatic brain injury. Nat Rev Neurol. 2013;9(4):231–6. doi:10.1038/nrneurol.2013.22.CrossRefPubMed

10.

WHO. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. Geneva: World Health Organization 2000.

11.

R-Core-Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2013. URL http://www.R-project.org/. Accessed 21 Oct 2014.

12.

Pohlert T. The Pairwise Multiple Comparison of Mean Ranks Package (PMCMR). 2014. R package.

13.

Steyerberg EW, Mushkudiani N, Perel P, Butcher I, Lu J, McHugh GS, et al. Predicting outcome after traumatic brain injury: development and international validation of prognostic scores based on admission characteristics. PLoS Med. 2008;5(8):e165. doi:10.1371/journal.pmed.0050165 (Discussion e).PubMedCentralCrossRefPubMed

14.

Ryb GE, Dischinger PC. Injury severity and outcome of overweight and obese patients after vehicular trauma: a crash injury research and engineering network (CIREN) study. J Trauma. 2008;64(2):406–11. doi:10.1097/TA.0b013e31802beff9.CrossRefPubMed

15.

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. doi:10.1016/j.jamcollsurg.2006.07.001.CrossRefPubMed

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.CrossRefPubMed

17.

Hoffmann M, Lefering R, Gruber-Rathmann M, Rueger JM, Lehmann W, Trauma Registry of the German Society for Trauma S. The impact of BMI on polytrauma outcome. Injury. 2012;43(2):184–8. doi:10.1016/j.injury.2011.05.029.CrossRefPubMed

18.

Jehle D, Gemme S, Jehle C. Influence of obesity on mortality of drivers in severe motor vehicle crashes. Am J Emerg Med. 2012;30(1):191–5. doi:10.1016/j.ajem.2010.10.017.CrossRefPubMed

19.

Mock CN, Grossman DC, Kaufman RP, Mack CD, Rivara FP. The relationship between body weight and risk of death and serious injury in motor vehicle crashes. Accid; Anal Prev. 2002;34(2):221–8.CrossRefPubMed

20.

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. doi:10.1001/archsurg.139.9.983.CrossRefPubMed

21.

Majdan M, Mauritz W, Wilbacher I, Janciak I, Brazinova A, Rusnak M, et al. Traumatic brain injuries caused by traffic accidents in five European countries: outcome and public health consequences. Eur J Pub Health. 2013;23(4):682–7. doi:10.1093/eurpub/cks074.CrossRef

Title: The impact of body mass index on severity, patterns and outcomes after traumatic brain injuries caused by low level falls
Authors: M. Majdan
A. Brazinova
I. Wilbacher
M. Rusnak
W. Mauritz
Publication date: 01-12-2015
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 6/2015
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-014-0490-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

The impact of body mass index on severity, patterns and outcomes after traumatic brain injuries caused by low level falls

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2015

Osteoligamentous injuries of the medial ankle joint

Electrical burn injuries secondary to copper theft

The accuracy of physical examination in identifying significant pathologies in penetrating thoracic trauma

An update on the evaluation and treatment of syndesmotic injuries

When do anterior external or internal fixators provide additional stability in an unstable (Tile C) pelvic fracture? A biomechanical study

Child drowning deaths in Aydin province, western Turkey, 2002–2012