OBESITY AND INCREASED MORTALITY IN BLUNT TRAUMA
OBESITY AND INCREASED MORTALITY IN BLUNT TRAUMA
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DOI：
10.1097/00005373-199109000-00009
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发表时间：
1991-09-01
影响因子：
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通讯作者：
MAYNES, C
中科院分区：
文献类型：
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作者：
CHOBAN, PS;WEIRETER, LJ;MAYNES, C
为了确定入院体重对钝性创伤患者的影响，对1987年1月1日至7月31日期间在森塔拉诺福克综合医院住院的所有> 12岁的患者进行了病历回顾。 351例患者的图表进行了审查，184个记录包含入院身高和体重。 这184例患者组成了研究组，记录了年龄、性别、损伤、损伤严重程度评分（ISS）、呼吸机天数（VD）、并发症、住院时间（LOS）和结局。 计算每例患者的体重指数（BMI）（体重（kg）/（身高（m））2）。 平均ISS为21.87（范围：1-66），平均BMI为25.15 kg/m2（范围：16-46 kg/m2）。 总死亡率为9%。 根据BMI将人群分组：平均（< 27 kg/m2），超重（27-31 kg/m2）和严重超重（> 31 kg/m2）。 平均和超重组的死亡率分别为5.0%和8.0%，无差异。 严重超重组的死亡率为42.1%，高于其他两组（p < 0.0001）。 各组在年龄、ISS、LOS和VD方面无差异。 对年龄、BMI和ISS进行回归分析。 通过这种方法，BMI和ISS是结果的独立决定因素（p < 0.0001）。 SO组并发症增加，主要是肺部问题（p < 0.05）。 这三组被分为幸存者和非幸存者。 与超重组（5.0天）或严重超重组（8.62天）相比，死亡组的平均LOS为26.6天（p < 0.007）。 严重超重组的特点是迅速恶化和死亡，对干预反应迟钝。 ISS在非幸存者中没有差异。 在幸存者中，严重超重组的ISS较低，为9.73。 这与超重组（21.57）和平均组（20.21）有差异（p < 0.04）。
To determine the effect of admission body weight on blunt trauma victims, a chart review of all patients > 12 years of age admitted to Sentara Norfolk General Hospital between January 1 and July 31, 1987 was undertaken. The charts of 351 patients were reviewed; 184 records contained admission height and weight. These 184 patients made up the study group and age, gender, injuries, Injury Severity Score (ISS), ventilator days (VD), complications, length of stay (LOS), and outcome were noted. Body Mass Index (BMI) (weight (kg)/(height (m))2, was calculated for each patient. The average ISS was 21.87 (range, 1-66) and the average BMI was 25.15 kg/m2 (range, 16-46 kg/m2). The overall mortality for the population was 9%. The population was grouped according to BMI: average (< 27 kg/m2), overweight (27-31 kg/m2), and severely overweight (> 31 kg/m2). The mortality of 5.0% and 8.0% in the average and overweight groups was not different. The severely overweight group had a higher mortality at 42.1% compared with the other two groups (p < 0.0001). The groups did not differ in age, ISS, LOS, nor VD. Age, BMI, and ISS were subjected to regression analysis. By this method BMI and ISS were independent determinants of outcome (p < 0.0001). There was an increase in complications, mainly pulmonary problems, in the SO group (p < 0.05). The three groups were subdivided into survivors and nonsurvivors. The nonsurvivors had a longer average LOS at 26.6 days compared with nonsurvivors in the overweight (5.0 days) or severely overweight (8.62 days) groups (p < 0.007). The severely overweight group was characterized by a rapid deterioration and demise that was unresponsive to intervention. ISS did not differ among nonsurvivors. Among survivors the severely overweight group had a lower ISS, 9.73. This was different from the overweight group (21.57) and from the average group (20.21) (p < 0.04).