The impact of body mass index on the development of systemic inflammatory response syndrome and sepsis in patients with polytrauma

作者：Mica Ladislav^*; Vomela Jindrich; Keel Marius; Trentz Otmar

来源：Injury-International Journal of the Care of the Injured, 2014, 45(1): 253-258.

DOI：10.1016/j.injury.2012.11.015

• Body mass index
• Polytrauma
• SIRS
• Sepsis
• C-reactive protein
• Interleukin-6
• Procalcitonin

Purpose: Obesity is a growing problem in industrial nations. Our aim was to examine how overweight patients coped with systemic inflammatory response syndrome (SIRS) after polytrauma.
Methods: A total of 651 patients were included in this retrospective study, with an ISS >= 16 and age >= 16 years. The sample was subdivided into three groups: body mass index (BMI; all in kg/m(2)) < 25, BMI 25-30 and BMI > 30, or low, intermediate and high BMI. The SIRS score was measured over 31 days after admission together with measurements of C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT). Data are given as the mean +/- SEM if not otherwise indicated. Kruskal-Wallis and chi(2) tests were used for statistical analysis and the significance level was set at p < .05.
Results: The maximum SIRS score was reached in the low BMI-group at 3.4 +/- 0.4, vs. 2.3 +/- 0.1 and 2.5 +/- 0.2 in the intermediate BMI-group and high BMI-group, respectively (p < .0001). However, the maximum SIRS score was reached earlier in the BMI 25-30 group at 1.8 +/- 0.2 days, vs. 3.4 +/- 0.4 and 2.5 +/- 0.2 days in the BMI < 25 and BMI > 30 groups, respectively (p < .0001). The incidence of sepsis was significantly higher in the low BMI group at 46.1%, vs. 0.2% and 0% in the BMI 25-30 and BMI > 30 groups, respectively (p < .0001). No significant differences in the CRP, IL-6 or PCT levels were found between groups.
Conclusions: A higher BMI seemed to be protective for these patients with polytrauma-associated inflammatory problems.

• 出版日期2014-1