Obese patients who fall have less injury severity but a longer hospital stay than normal-weight patients

作者：Chuang Jung Fang; Rau Cheng Shyuan; Liu Hang Tsung; Wu Shao Chun; Chen Yi Chun; Hsu Shiun Yuan; Hsieh Hsiao Yun; Hsieh Ching Hua^*

来源：World Journal of Emergency Surgery, 2016, 11(1): 3.

DOI：10.1186/s13017-015-0059-9

• Fall
• Obesity
• Injury severity score
• Mortality
• In hospital length of stay

Background: The effects of obesity on injury severity and outcome have been studied in trauma patients but not in those who have experienced a fall. The aim of this study was to compare injury patterns, injury severities, mortality rates, and in-hospital or intensive care unit (ICU) length of stay (LOS) between obese and normal-weight patients following a fall.
Methods: Detailed data were retrieved for 273 fall-related hospitalized obese adult patients with a body mass index (BMI) >= 30 kg/ m(2) and 2357 normal-weight patients with a BMI < 25 kg/ m(2) but >= 18.5 kg/ m(2) from the Trauma Registry System of a Level I trauma center between January 1, 2009, and December 31, 2013. We used the Pearson's chi-squared test, Fisher's exact test, the Mann Whitney U test, and independent Student's t- test to analyze differences between the two groups.
Results: Analysis of AIS scores and AIS severity scaling from 1 to 5 revealed no significant differences in trauma regions between obese and normal-weight patients. When stratified by injury severity (Injury Severity Score [ISS] of < 16, 16-24, or >= 25), more obese patients had an ISS of < 16 compared to normal- weight patients (90.5 % vs. 86.0 %, respectively; p = 0.041), while more normal- weight patients had an ISS between 16 and 24 (11.0 % vs. 6.6 %, respectively; p = 0.025). Obese patients who had experienced a fall had a significantly lower ISS (median (range): 9 (1- 45) vs. 9 (1- 50), respectively; p = 0.015) but longer in- hospital LOS than did normal- weight patients (10.1 days vs. 8.9 days, respectively; p = 0.049). Even after taking account of possible differences in comorbidity and ISS, the obese patients have an average 1.54 day longer LOS than that of normal- weight patients. However, no significant differences were found between obese and normal- weight patients in terms of the New Injury Severity Score (NISS), Trauma Injury Severity Score (TRISS), mortality, percentage of patients admitted to the ICU, or LOS in the ICU.
Conclusion: Obese patients who had experienced a fall did not have different injured body regions than did normal- weight patients. However, they had a lower ISS but a longer in- hospital LOS than did normal- weight patients.

• 出版日期2016-1-4
• 单位长春大学