Table 1: Summary of clinical studies examining the impact of obesity on mortality in Trauma Intensive care Units
Studies
Choban et
al.1991 (36)
Study design
Retrospective
Single center
Neville et al.
2004 (40)
Prospective
Case-control
Single center
Brown et al.
2005 (93)
Retrospective
Single center
Byrnes et al
2005 (38)
Retrospective
Single center
Bochicchio et
al. 2006 (41)
Prospective
Single center
Ryb et al. 2008
(39)
Retrospective
Multicenter
Duchesne et al.
2009 (96)
Retrospective
Single center
Nelson et al,
2012 (74)
Retrospective
Single center
Ditillo et al.
2014 (28)
Retrospective
Single center
Glance et al.
2014 (37)
Retrospective
Multicenter
Number of groups, BMI in kg/m2
(number of patients)
Type of ICU
Conclusions
3 groups:
BMI > 27(140)
BMI: 27-31(25)
BMI >31 (31)
Trauma
Mortality rate was higher in obese than normalweight and overweight patients
2 groups:
BMI < 30 (63)
BMI > 30 (179)
Trauma
2 groups:
BMI < 30 (870)
BMI > 30 (283)
Trauma
Obesity was independently associated with
mortality rate, LOS and days of mechanical
ventilation
5 groups
BMI <25 (488)
BMI:25-29.9 (401)
BMI: 30-34.9 (168)
BMI: 35-39.9 (65),
BMI> 40 (57)
Trauma
Obesity increased mortality and ICU
complications.
Mortality rate for obese patient increased with
the severity of injuries (ISS > 15)
2 groups:
BMI < 30–49 (1105)
BMI ≥ 49 (62)
Trauma
Obesity increased mortality and in-hospital
complications including LOS
3 groups:
BMI: 18.5-25 (n = 619)
BMI 25-30 (n = 561), >30 (n = 437)
Patients from the CIREN database
Trauma
Mortality rate was 2 fold higher in obese
patients compared to lean patients
3 groups:
BMI<29 (51)
BMI 30-39 (38)
BMI >40 (15)
Trauma
Morbid obesity is associated with higher
mortality rate and increased complications
including LOS, postoperative infection, length
of ventilation support and multiple organ failure
4 groups:
BMI < 18.5 (30)
BMI:18.5–24.9 (603)
BMI: 25.0–29.9 (361)
BMI: > 30 (90)
Trauma
Obesity increased mortality rate and incidence
of multiple organ failure, but did not affect LOS
in patients with ISS ≥ 16
2 groups:
BMI < 40 (16,390)
BMI > 40 (16,390)
Patient from NTDB database with blunt
trauma and matched-injury scores
Trauma
Morbid obesity increased mortality, in-hospital
complications and LOS
6 groups classified in percentile using
the empiric weight distributions.
Underweight (1248)
Reference (109582)
Grade 1 obesity (20970)
Grade 2 obesity (8131)
Grade 3 obesity (6084)
Grade 4 obesity (1665)
Exclusion of non trauma patients
Trauma
Severe obesity increased mortality rate, organ
failure and wound-related complications
Obesity increased mortality and incidence of
multiple organ failure
Abbreviations: The number of patients in each weight category is listed in parenthesis. BMI, body mass index in kg/m2; ISS; injury severity, LOS,
length of stay. NTDB, National Trauma Data Bank. CIREN, Crash Injury Research and Engineering Network database.