• World journal of surgery · Mar 2020

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

    • 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, and Faran Bokhari.
    • Department of Trauma and Burn Surgery, Stroger Hospital of Cook County, Rush University, 1950 West Polk Street, 8th floor, Chicago, IL, 60612, USA.
    • World J Surg. 2020 Mar 1; 44 (3): 755-763.

    IntroductionObesity 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.MethodsAbdominal 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.ResultsA 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.ConclusionsObesity 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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