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01-03-2020 | Laparotomy | Original Scientific Report

Obesity is Associated with Worse Outcomes Among Abdominal Trauma Patients Undergoing Laparotomy: A Propensity-Matched Nationwide Cohort Study

Authors: Chih-Yuan Fu, Francesco Bajani, Marissa Bokhari, Leah C. Tatebe, Frederick Starr, Thomas Messer, Matthew Kaminsky, Andrew Dennis, Victoria Schlanser, Justin Mis, Rubinder Toor, Stathis Poulakidas, Faran Bokhari

Published in: World Journal of Surgery | Issue 3/2020

Abstract

Introduction

Obesity is associated with increased morbidity and mortality in abdominal trauma patients. The characteristics of abdominal trauma patients with poor outcomes related to obesity require evaluation. We hypothesize that obesity is related to increased mortality and length of stay (LOS) among abdominal trauma patients undergoing laparotomies.

Methods

Abdominal trauma patients were identified from the National Trauma Data Bank between 2013 and 2015. Patients who received laparotomies were analyzed using propensity score matching (PSM) to evaluate the mortality rate and LOS between obese and non-obese patients. Patients without laparotomies were analyzed as a control group using PSM cohort analysis.

Results

A total of 33,798 abdominal trauma patients were evaluated, 10,987 of them received laparotomies. Of these patients, the proportion of obesity in deceased patients was significantly higher when compared to the survivors (33.1% vs. 26.2%, p < 0.001). Elevation of one kg/m² of body mass index independently resulted in 2.5% increased odds of mortality. After a well-balanced PSM, obese patients undergoing laparotomies had significantly higher mortality rates [3.7% vs. 2.4%, standardized difference (SD) = 0.241], longer hospital LOS (11.1 vs. 9.6 days, SD = 0.135), and longer intensive care unit LOS (3.5 vs. 2.3 days, SD = 0.171) than non-obese patients undergoing laparotomies.

Conclusions

Obesity is associated with increased mortality in abdominal trauma patients who received laparotomies versus those who did not. Obesity requires a careful evaluation of alternatives to laparotomy in injured patients.

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Title: Obesity is Associated with Worse Outcomes Among Abdominal Trauma Patients Undergoing Laparotomy: A Propensity-Matched Nationwide Cohort Study
Authors: Chih-Yuan Fu
Francesco Bajani
Marissa Bokhari
Leah C. Tatebe
Frederick Starr
Thomas Messer
Matthew Kaminsky
Andrew Dennis
Victoria Schlanser
Justin Mis
Rubinder Toor
Stathis Poulakidas
Faran Bokhari
Publication date: 01-03-2020
Publisher: Springer International Publishing
Keywords: Laparotomy
Obesity
Obesity
Laparotomy
Abdominal Trauma
Published in: World Journal of Surgery / Issue 3/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05268-5

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Obesity is Associated with Worse Outcomes Among Abdominal Trauma Patients Undergoing Laparotomy: A Propensity-Matched Nationwide Cohort Study

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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