Isolated severe blunt traumatic brain injury: effect of obesity on outcomes.

Journal of Neurosurgery
Jennifer T ConeDemetrios Demetriades

Abstract

Obesity has been widely reported to confer significant morbidity and mortality in both medical and surgical patients. However, contemporary data indicate that obesity may confer protection after both critical illness and certain types of major surgery. The authors hypothesized that this "obesity paradox" may apply to patients with isolated severe blunt traumatic brain injuries (TBIs). The Trauma Quality Improvement Program (TQIP) database was queried for patients with isolated severe blunt TBI (head Abbreviated Injury Scale [AIS] score 3-5, all other body areas AIS < 3). Patient data were divided based on WHO classification levels for BMI: underweight (< 18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), obesity class 1 (30.0-34.9 kg/m2), obesity class 2 (35.0-39.9 kg/m2), and obesity class 3 (≥ 40.0 kg/m2). The role of BMI in patient outcomes was assessed using regression models. In total, 103,280 patients were identified with isolated severe blunt TBI. Data were excluded for patients aged < 20 or > 89 years or with BMI < 10 or > 55 kg/m2 and for patients who were transferred from another treatment center or who showed no signs of life upon presentation, leaving data from 38,446 patients for analysis. ...Continue Reading

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Oct 24, 2020·Intensive Care Medicine·Audrey De JongSamir Jaber

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