Open AccessObesity is Associated with Worse Outcomes Among Abdominal Trauma Patients Undergoing Laparotomy: A Propensity‐Matched Nationwide Cohort Study
Author(s) -
Fu ChihYuan,
Bajani Francesco,
Bokhari Marissa,
Tatebe Leah C.,
Starr Frederick,
Messer Thomas,
Kaminsky Matthew,
Dennis Andrew,
Schlanser Victoria,
Mis Justin,
Toor Rubinder,
Poulakidas Stathis,
Bokhari Faran
Publication year - 2020
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-019-05268-5
Subject(s) - medicine , abdominal surgery , laparotomy , propensity score matching , body mass index , abdominal obesity , obesity , intensive care unit , odds ratio , abdominal trauma , cohort , mortality rate , cardiac surgery , surgery , vascular surgery , metabolic syndrome , blunt
Obesity is associated with increased morbidity and mortality in abdominal trauma patients. The characteristics of abdominal trauma patients with poor outcomes related to obesity require evaluation. We hypothesize that obesity is related to increased mortality and length of stay (LOS) among abdominal trauma patients undergoing laparotomies. Methods Abdominal trauma patients were identified from the National Trauma Data Bank between 2013 and 2015. Patients who received laparotomies were analyzed using propensity score matching (PSM) to evaluate the mortality rate and LOS between obese and non‐obese patients. Patients without laparotomies were analyzed as a control group using PSM cohort analysis. Results A total of 33,798 abdominal trauma patients were evaluated, 10,987 of them received laparotomies. Of these patients, the proportion of obesity in deceased patients was significantly higher when compared to the survivors (33.1% vs. 26.2%, p < 0.001). Elevation of one kg/m 2 of body mass index independently resulted in 2.5% increased odds of mortality. After a well‐balanced PSM, obese patients undergoing laparotomies had significantly higher mortality rates [3.7% vs. 2.4%, standardized difference (SD) = 0.241], longer hospital LOS (11.1 vs. 9.6 days, SD = 0.135), and longer intensive care unit LOS (3.5 vs. 2.3 days, SD = 0.171) than non‐obese patients undergoing laparotomies. Conclusions Obesity is associated with increased mortality in abdominal trauma patients who received laparotomies versus those who did not. Obesity requires a careful evaluation of alternatives to laparotomy in injured patients.