• Ladislav Mica, Marius Keel, and Otmar Trentz.
• Division of Trauma Surgery, University Hospital of Zürich, Zurich, Switzerland. ladislav.mica@usz.ch
• J Crit Care. 2012 Dec 1;27(6):722-6.

PurposeObesity is a growing problem in industrial nations. The aim was to test the hypothesis that overweight patients face early physiologic impairment.MethodsA total of 651 patients were included in this retrospective study, with an injury severity score greater than 16 and 16 years or older. The sample was subdivided into 3 groups: body mass index (BMI) less than 25 kg/m(2), BMI of 25 to 30 kg/m(2), and BMI greater than 30 kg/m(2). Physiologic scores-Murray, Goris, Marshall and Sequential Organ Failure Assessment scores-were analyzed at admission and at the day of their maximum. Analysis of variance and χ(2) tests were used, and the significance level was set at P < .05.ResultsAll 4 scores showed significant differences at their maxima according to the 3 BMI groups, respectively: Murray score (P < .001), Goris score (P < .05), Marshall score (P < .001), and Sequential Organ Failure Assessment score (P <.05). The injury severity score values of the 3 groups at admission were 27.6 ± 12.0, 29.6 ± 13.2, and 25.3 ± 9.2, respectively (P < .05). The overall mortality rates in the 3 groups were 15.1%, 21.0%, and 20%, respectively (P < .001).ConclusionsAnticipating BMI-specific critical trauma problems will become mandatory for effective polytrauma treatment in industrialized nations given their increasing prevalence of obesity.Copyright © 2012 Elsevier Inc. All rights reserved.

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