The cushion effect
The cushion effect
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DOI：
10.1097/01.ta.0000064449.11809.48
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发表时间：
2003-06-01
影响因子：
--
通讯作者：
Wang, SC
中科院分区：
文献类型：
--
作者：
Arbabi, S;Wahl, WL;Wang, SC
背景资料：碰撞损伤的模式和严重程度取决于生物力学因素的复杂相互作用，如碰撞时的减速速度（delta-V）、安全带和安全气囊的使用以及碰撞类型。身高和体重等人体特征可能起重要作用。我们假设，身体质量指数（BMI）将影响碰撞伤害patternes.Methods：密歇根大学程序伤害研究和教育数据库进行查询。分析了三个队列，瘦（BMI小于或等于25 kg/m2），超重（BMI 25-30 kg/m2）和肥胖（BMI > 30 kg/m2）。与肥胖队列相关的致死性结局风险增加（与瘦队列相比，调整后的比值比为4.2; p = 0.04）。年龄，三角洲V，安全带的使用，和类型的影响是独立的预测损伤严重程度评分（ISS）。在调整了其他因素后，与瘦人群相比，超重与ISS（p = 0.03）和腹部最大简明损伤量表（迈斯）评分（p = 0.008）降低相关。然而，下肢迈斯评分增加时，超重（p = 0.03）和肥胖队列（p = 0.001）与瘦coherent.Conclusion相比：虽然没有发现瘦和肥胖队列之间的ISS差异，有肥胖队列的死亡率增加。下肢损伤的严重程度随着BMI的增加而增加。与瘦人群相比，超重人群的ISS和腹部迈斯评分较低。这种保护可以归因于绝缘组织的增加，或“缓冲效应”，而不会显著增加质量和动量。
Background: The pattern and severity of crash injury depends on a complex interaction of biomechanical factors such as deceleration velocity at impact (delta-V), seat-belt and airbag use, and type of impact. Human body characteristics such as height and weight may play an important role. We hypothesized that body mass index (BMI) will influence crash injury patterns.Methods: The University of Michigan Program for Injury Research and Education database was queried. Three cohorts were analyzed, lean (BMI less than or equal to 25 kg/m(2)), overweight (BMI 25-30 kg/m(2)), and obese (BMI > 30 kg/m(2)).Results: There were 189 detailed crash cases, with 22 fatalities. There was an increased risk of fatal outcome associated with the obese cohort (adjusted odds ratio, 4.2 compared with lean; p = 0.04). Age, delta-V, seat-belt use, and type of impact were independent predictors of Injury Severity Score (ISS). After adjusting for other modifiers, being overweight was associated with decreased ISS (p = 0.03) and abdominal maximal Abbreviated Injury Scale (mAIS) score (p = 0.008) when compared with the lean cohort. However, the lower extremity mAIS score increased when overweight (p = 0.03) and obese cohorts (p = 0.001) were compared with the lean cohort.Conclusion: Although no difference in ISS was identified between the lean and obese cohorts, there was an increase in mortality with the obese cohort. The severity of lower extremity injuries increased with increasing BMI. The overweight cohort was associated with lower ISS and abdominal mAIS score compared with the lean cohort. This protection may be attributable to an increase in insulating tissue, or a "cushion effect," without a significant increase in mass and momentum.