Skip to main content
Top
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2016

Open Access 01-12-2016 | Original research

Obese motorcycle riders have a different injury pattern and longer hospital length of stay than the normal-weight patients

Authors: Hang-Tsung Liu, Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Shiun-Yuan Hsu, Hsiao-Yun Hsieh, Ching-Hua Hsieh

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2016

Login to get access

Abstract

Background

The adverse effects of obesity on the physical health have been extensively studied in the general population, but not in motorcycle riders (includes both drivers and pillions). The aim of this study was to compare injury patterns, injury severities, mortality rates, and in-hospital or intensive care unit (ICU) length of stay (LOS) between obese and normal-weight patients who were hospitalized for the treatment of trauma following motorcycle accidents in a level I trauma center.

Methods

Detailed data of 466 obese adult patients with a body mass index (BMI) ≥30 kg/m2 and 2701 normal-weight patients (25 > BMI ≥18.5 kg/m2) who had sustained motorcycle accident-related injuries were retrieved from the Trauma Registry System between January 1, 2009 and December 31, 2013. We used the Pearson’s chi-squared test, Fisher’s exact test, and independent Student’s t-test to analyze differences between the two groups.

Results

Compared to normal-weight motorcycle riders, more obese riders were men and drivers as opposed to pillions. In addition, fewer obese motorcycle riders showed alcohol intoxication. Analyses of the patients’ Abbreviated Injury Scale (AIS) scores revealed that obese motorcycle riders presented with a higher rate of injury to the thorax, but a lower rate of injury to the face than normal-weight patients. In addition, obese motorcycle riders had a 2.7-fold greater incidence of humeral, 1.9-fold greater incidence of pelvic, and 1.5-fold greater incidence of rib fractures. In contrast, normal-weight motorcycle riders sustained a significantly higher rate of maxillary and clavicle fractures. Obese motorcycle riders had a significant longer in-hospital LOS than normal-weight motorcycle riders did (10.6 days vs. 9.5 days, respectively; p = 0.044), with an increase in in-hospital LOS of 0.82 days associated with every 10-unit increase in BMI. No statistically significant differences in Injury Severity Score (ISS), New Injury Severity Score (NISS), Trauma-Injury Severity Score (TRISS), mortality, percentage of patients admitted to the ICU, or LOS in the ICU were found between obese and normal-weight patients.

Discussion

No differences of injury severity, mortality, and LOS in the ICU between obese and normal-weight motorcycle riders in this study may be partly attributed to the motorcycle injuries occur at relatively low velocity, considering that the riding of majority of motorcycles are forbidden on highways in Taiwan and that most traffic accidents occur in relatively crowded streets.

Conclusion

Obese motorcycle riders had different injury characteristics and bodily injury patterns than normal-weight motorcycle riders. Moreover, they had a longer in-hospital LOS; this was particularly true for those with pelvic fractures. However, injury severity and mortality were not significantly different between the two groups.
Literature
1.
go back to reference Pi-Sunyer FX. The obesity epidemic: pathophysiology and consequences of obesity. Obes Res. 2002;10 Suppl 2:97s–104.CrossRefPubMed Pi-Sunyer FX. The obesity epidemic: pathophysiology and consequences of obesity. Obes Res. 2002;10 Suppl 2:97s–104.CrossRefPubMed
2.
go back to reference Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes. 2006;1(1):11–25.CrossRefPubMed Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes. 2006;1(1):11–25.CrossRefPubMed
3.
go back to reference Rosenfeld HE, Tsokos M, Byard RW. The association between body mass index and pulmonary thromboembolism in an autopsy population. J Forensic Sci. 2012;57(5):1336–8.CrossRefPubMed Rosenfeld HE, Tsokos M, Byard RW. The association between body mass index and pulmonary thromboembolism in an autopsy population. J Forensic Sci. 2012;57(5):1336–8.CrossRefPubMed
4.
go back to reference Childs BR, Nahm NJ, Dolenc AJ, Vallier HA. Obesity is associated with more complications and longer hospital stays after orthopaedic trauma. J Orthop Trauma. 2015;29(11):504-9. Childs BR, Nahm NJ, Dolenc AJ, Vallier HA. Obesity is associated with more complications and longer hospital stays after orthopaedic trauma. J Orthop Trauma. 2015;29(11):504-9.
5.
go back to reference Hoffmann M, Lefering R, Gruber-Rathmann M, Rueger JM, Lehmann W. The impact of BMI on polytrauma outcome. Injury. 2012;43(2):184–8.CrossRefPubMed Hoffmann M, Lefering R, Gruber-Rathmann M, Rueger JM, Lehmann W. The impact of BMI on polytrauma outcome. Injury. 2012;43(2):184–8.CrossRefPubMed
6.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
7.
go back to reference 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 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
8.
go back to reference Zhu S, Layde PM, Guse CE, Laud PW, Pintar F, Nirula R, Hargarten S. Obesity and risk for death due to motor vehicle crashes. Am J Public Health. 2006;96(4):734–9.CrossRefPubMedPubMedCentral Zhu S, Layde PM, Guse CE, Laud PW, Pintar F, Nirula R, Hargarten S. Obesity and risk for death due to motor vehicle crashes. Am J Public Health. 2006;96(4):734–9.CrossRefPubMedPubMedCentral
9.
go back to reference Diaz Jr JJ, Norris PR, Collier BR, Berkes MB, Ozdas A, May AK, Miller RS, Morris JA, Jr. Morbid obesity is not a risk factor for mortality in critically ill trauma patients. J Trauma. 2009;66(1):226–31.CrossRefPubMed Diaz Jr JJ, Norris PR, Collier BR, Berkes MB, Ozdas A, May AK, Miller RS, Morris JA, Jr. Morbid obesity is not a risk factor for mortality in critically ill trauma patients. J Trauma. 2009;66(1):226–31.CrossRefPubMed
10.
go back to reference Morris Jr JA, MacKenzie EJ, Edelstein SL. The effect of preexisting conditions on mortality in trauma patients. JAMA. 1990;263(14):1942–6.CrossRefPubMed Morris Jr JA, MacKenzie EJ, Edelstein SL. The effect of preexisting conditions on mortality in trauma patients. JAMA. 1990;263(14):1942–6.CrossRefPubMed
12.
go back to reference Livingston DH, Lavery RF, N’Kanza A, Anjaria D, Sifri ZC, Mohr AM, Mosenthal AC. Obesity does not increase morbidity and mortality after laparotomy for trauma. Am Surg. 2013;79(3):247–52.PubMed Livingston DH, Lavery RF, N’Kanza A, Anjaria D, Sifri ZC, Mohr AM, Mosenthal AC. Obesity does not increase morbidity and mortality after laparotomy for trauma. Am Surg. 2013;79(3):247–52.PubMed
13.
go back to reference Deasy C, Gabbe B, Palmer C, Babl FE, Bevan C, Crameri J, Butt W, Fitzgerald M, Judson R, Cameron P. Paediatric and adolescent trauma care within an integrated trauma system. Injury. 2012;43(12):2006–11.CrossRefPubMed Deasy C, Gabbe B, Palmer C, Babl FE, Bevan C, Crameri J, Butt W, Fitzgerald M, Judson R, Cameron P. Paediatric and adolescent trauma care within an integrated trauma system. Injury. 2012;43(12):2006–11.CrossRefPubMed
15.
go back to reference Byard RW, Langlois NE. Letter to the editor--Increasing body weight of motorcycle riders. J Forensic Sci. 2011;56(6):1661.CrossRefPubMed Byard RW, Langlois NE. Letter to the editor--Increasing body weight of motorcycle riders. J Forensic Sci. 2011;56(6):1661.CrossRefPubMed
16.
go back to reference Densmore JC, Lim HJ, Oldham KT, Guice KS. Outcomes and delivery of care in pediatric injury. J Pediatr Surg. 2006;41(1):92–8. discussion 92–98.CrossRefPubMed Densmore JC, Lim HJ, Oldham KT, Guice KS. Outcomes and delivery of care in pediatric injury. J Pediatr Surg. 2006;41(1):92–8. discussion 92–98.CrossRefPubMed
17.
go back to reference Rogers SC, Campbell BT, Saleheen H, Borrup K, Lapidus G. Using trauma registry data to guide injury prevention program activities. J Trauma. 2010;69(4 Suppl):S209–13.CrossRefPubMed Rogers SC, Campbell BT, Saleheen H, Borrup K, Lapidus G. Using trauma registry data to guide injury prevention program activities. J Trauma. 2010;69(4 Suppl):S209–13.CrossRefPubMed
18.
go back to reference WHO Expert Committee on Physical Status. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser 1995;854:1–452. WHO Expert Committee on Physical Status. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser 1995;854:1–452.
19.
go back to reference Program of Nutrition Family and Reproductive Health. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000, 894:i-xii, 1–253. Program of Nutrition Family and Reproductive Health. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000, 894:i-xii, 1–253.
20.
go back to reference Boulanger BR, Milzman D, Mitchell K, Rodriguez A. Body habitus as a predictor of injury pattern after blunt trauma. J Trauma. 1992;33(2):228–32.CrossRefPubMed Boulanger BR, Milzman D, Mitchell K, Rodriguez A. Body habitus as a predictor of injury pattern after blunt trauma. J Trauma. 1992;33(2):228–32.CrossRefPubMed
21.
go back to reference 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 1051.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 1051.CrossRefPubMed
22.
go back to reference Jou RC, Yeh TH, Chen RS. Risk factors in motorcyclist fatalities in Taiwan. Traffic Inj Prev. 2012;13(2):155–62.CrossRefPubMed Jou RC, Yeh TH, Chen RS. Risk factors in motorcyclist fatalities in Taiwan. Traffic Inj Prev. 2012;13(2):155–62.CrossRefPubMed
23.
go back to reference Tsai J, Ford ES, Zhao G, Li C, Greenlund KJ, Croft JB. Co-occurrence of obesity and patterns of alcohol use associated with elevated serum hepatic enzymes in US adults. J Behav Med. 2012;35(2):200–10.CrossRefPubMed Tsai J, Ford ES, Zhao G, Li C, Greenlund KJ, Croft JB. Co-occurrence of obesity and patterns of alcohol use associated with elevated serum hepatic enzymes in US adults. J Behav Med. 2012;35(2):200–10.CrossRefPubMed
24.
go back to reference Ely M, Hardy R, Longford NT, Wadsworth ME. Gender differences in the relationship between alcohol consumption and drink problems are largely accounted for by body water. Alcohol Alcohol. 1999;34(6):894–902.CrossRefPubMed Ely M, Hardy R, Longford NT, Wadsworth ME. Gender differences in the relationship between alcohol consumption and drink problems are largely accounted for by body water. Alcohol Alcohol. 1999;34(6):894–902.CrossRefPubMed
25.
go back to reference Matsumoto T, Fukaya Y, Yokomori M. Effects of different weight loads on the body during motorcycle riding. Scand J Work Environ Health. 1986;12(4 Spec No):385–8.CrossRefPubMed Matsumoto T, Fukaya Y, Yokomori M. Effects of different weight loads on the body during motorcycle riding. Scand J Work Environ Health. 1986;12(4 Spec No):385–8.CrossRefPubMed
26.
go back to reference Sems SA, Johnson M, Cole PA, Byrd CT, Templeman DC. Elevated body mass index increases early complications of surgical treatment of pelvic ring injuries. J Orthop Trauma. 2010;24(5):309–14.CrossRefPubMed Sems SA, Johnson M, Cole PA, Byrd CT, Templeman DC. Elevated body mass index increases early complications of surgical treatment of pelvic ring injuries. J Orthop Trauma. 2010;24(5):309–14.CrossRefPubMed
27.
go back to reference Porter SE, Graves ML, Maples RA, Woodall Jr J, Wallace JG, Russell GV. Acetabular fracture reductions in the obese patient. J Orthop Trauma. 2011;25(6):371–7.CrossRefPubMed Porter SE, Graves ML, Maples RA, Woodall Jr J, Wallace JG, Russell GV. Acetabular fracture reductions in the obese patient. J Orthop Trauma. 2011;25(6):371–7.CrossRefPubMed
Metadata
Title
Obese motorcycle riders have a different injury pattern and longer hospital length of stay than the normal-weight patients
Authors
Hang-Tsung Liu
Cheng-Shyuan Rau
Shao-Chun Wu
Yi-Chun Chen
Shiun-Yuan Hsu
Hsiao-Yun Hsieh
Ching-Hua Hsieh
Publication date
01-12-2016
Publisher
BioMed Central
DOI
https://doi.org/10.1186/s13049-016-0241-4

Other articles of this Issue 1/2016

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2016 Go to the issue