Purpose of Study The currently used prognostic scoring systems for trauma patients do not include body mass index (BMI). We hypothesized that obese trauma patients admitted to the intensive care unit have a higher morbidity and mortality.
Methods This retrospective observational study examined 297 adults admitted for more than 3 days to the Trauma ICU at OUHSC from January until August 2004 by review of hospital discharge logs. Forty-five patients who died in the ER or within the first 48 hours were excluded, as were 20 additional patients with insufficient data. Clinical characteristics and outcome were determined by review of the medical record. We classified the patients as underweight (BMI<18.5), normal (BMI: 18.5-24.9), overweight (BMI: 24.9-29.9), and obese (BMI>30). Data are presented as mean ± SEM.
Results Gender, ethnic background, vital signs, need for mechanical ventilation (MV), GCS and severity of illness scores were similar between obese and non-obese. Patients were young with a mean age of 38.2 ± 1.2 years. Trauma obese patients had a longer ICU LOS (12.7 ± 1.3 vs. 10.2 ± 1.3 days; p<0.05) with a similar duration of MV (8.2 ± 1.3 vs. 6.9 ± 1.4 days; p = 0.34) when compared to non-obese patients. Overall, the obese group also had increased plasma creatinine (1.24 ± 0.06 vs. 1.08 ± 0.05; p<0.05), glucose levels (168 ± 6 vs. 154 ± 4; p<0.05) and a lower PaO2 (106 ± 13 vs. 150 ± 10; p<0.05).
Conclusion Obesity, which is common in the United States, may be associated with an increased ICU LOS and consequently increased health care costs in trauma patients admitted to the intensive care unit.