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Protective Role of Obesity on Trauma Impact: A Retrospective Analysis of Patients with Surgical Blunt Bowel Mesenteric Injury Due to Road Traffic Accidents
BACKGROUND: The “cushion effect” theory proposes that increased body mass index (BMI) is associated with less severe abdomen injury following blunt abdomen trauma, while the “obesity paradox” describes the protective effect of obesity against mortality. However, most previous studies used the abdomi...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9395217/ https://www.ncbi.nlm.nih.gov/pubmed/36003412 http://dx.doi.org/10.2147/RMHP.S374469 |
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author | Hsieh, Ting-Min Chuang, Po-Chun Liu, Chun-Ting Wu, Bei-Yu Liu, Yueh-Wei Hsieh, Ching-Hua |
author_facet | Hsieh, Ting-Min Chuang, Po-Chun Liu, Chun-Ting Wu, Bei-Yu Liu, Yueh-Wei Hsieh, Ching-Hua |
author_sort | Hsieh, Ting-Min |
collection | PubMed |
description | BACKGROUND: The “cushion effect” theory proposes that increased body mass index (BMI) is associated with less severe abdomen injury following blunt abdomen trauma, while the “obesity paradox” describes the protective effect of obesity against mortality. However, most previous studies used the abdominal abbreviated injury scale as the outcomes seemed to be inadequate owing to the injuries to the abdominal organs, such as the spleen and liver, which may be attributable to the force that caused the chest trauma. This study aimed to use adult trauma patients with surgical blunt bowel mesenteric injuries (BBMIs) to investigate the influence of obesity on the clinical outcomes and overall morbidities. METHODS: This retrospective study reviewed the data of all hospitalized trauma patients between 2009 and 2019 and included all patients with surgically proven small bowel, colon, or mesenteric injuries due to a road traffic accident. Comparison of the outcomes was performed among 123 patients with surgically proven BBMI, who were categorized by BMI into the normal-weight (n = 73, BMI<25 kg/m(2)), overweight (n = 37, 25≤BMI≤30 kg/m(2)), and obese groups (n = 13, BMI>30 kg/m(2)). RESULTS: The obese group had a significantly lower incidence of isolated bowel injury (0%) compared with the normal-weight (35.6%) and overweight (16.2%) groups (p=0.005), but with higher incidence of isolated mesenteric injury or combined injury, although this was not significant. The obese group (92.3%) had a significantly higher percentage of overall morbidity than the normal-weight (61.6%) and overweight (70.3%) groups (p = 0.047). No significant difference was observed in the in-hospital mortality and 24-hour mortality among the three study groups. CONCLUSION: The study findings do not support the existence of a cushion effect and obesity paradox of obesity in blunt abdominal trauma. |
format | Online Article Text |
id | pubmed-9395217 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-93952172022-08-23 Protective Role of Obesity on Trauma Impact: A Retrospective Analysis of Patients with Surgical Blunt Bowel Mesenteric Injury Due to Road Traffic Accidents Hsieh, Ting-Min Chuang, Po-Chun Liu, Chun-Ting Wu, Bei-Yu Liu, Yueh-Wei Hsieh, Ching-Hua Risk Manag Healthc Policy Original Research BACKGROUND: The “cushion effect” theory proposes that increased body mass index (BMI) is associated with less severe abdomen injury following blunt abdomen trauma, while the “obesity paradox” describes the protective effect of obesity against mortality. However, most previous studies used the abdominal abbreviated injury scale as the outcomes seemed to be inadequate owing to the injuries to the abdominal organs, such as the spleen and liver, which may be attributable to the force that caused the chest trauma. This study aimed to use adult trauma patients with surgical blunt bowel mesenteric injuries (BBMIs) to investigate the influence of obesity on the clinical outcomes and overall morbidities. METHODS: This retrospective study reviewed the data of all hospitalized trauma patients between 2009 and 2019 and included all patients with surgically proven small bowel, colon, or mesenteric injuries due to a road traffic accident. Comparison of the outcomes was performed among 123 patients with surgically proven BBMI, who were categorized by BMI into the normal-weight (n = 73, BMI<25 kg/m(2)), overweight (n = 37, 25≤BMI≤30 kg/m(2)), and obese groups (n = 13, BMI>30 kg/m(2)). RESULTS: The obese group had a significantly lower incidence of isolated bowel injury (0%) compared with the normal-weight (35.6%) and overweight (16.2%) groups (p=0.005), but with higher incidence of isolated mesenteric injury or combined injury, although this was not significant. The obese group (92.3%) had a significantly higher percentage of overall morbidity than the normal-weight (61.6%) and overweight (70.3%) groups (p = 0.047). No significant difference was observed in the in-hospital mortality and 24-hour mortality among the three study groups. CONCLUSION: The study findings do not support the existence of a cushion effect and obesity paradox of obesity in blunt abdominal trauma. Dove 2022-08-18 /pmc/articles/PMC9395217/ /pubmed/36003412 http://dx.doi.org/10.2147/RMHP.S374469 Text en © 2022 Hsieh et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Hsieh, Ting-Min Chuang, Po-Chun Liu, Chun-Ting Wu, Bei-Yu Liu, Yueh-Wei Hsieh, Ching-Hua Protective Role of Obesity on Trauma Impact: A Retrospective Analysis of Patients with Surgical Blunt Bowel Mesenteric Injury Due to Road Traffic Accidents |
title | Protective Role of Obesity on Trauma Impact: A Retrospective Analysis of Patients with Surgical Blunt Bowel Mesenteric Injury Due to Road Traffic Accidents |
title_full | Protective Role of Obesity on Trauma Impact: A Retrospective Analysis of Patients with Surgical Blunt Bowel Mesenteric Injury Due to Road Traffic Accidents |
title_fullStr | Protective Role of Obesity on Trauma Impact: A Retrospective Analysis of Patients with Surgical Blunt Bowel Mesenteric Injury Due to Road Traffic Accidents |
title_full_unstemmed | Protective Role of Obesity on Trauma Impact: A Retrospective Analysis of Patients with Surgical Blunt Bowel Mesenteric Injury Due to Road Traffic Accidents |
title_short | Protective Role of Obesity on Trauma Impact: A Retrospective Analysis of Patients with Surgical Blunt Bowel Mesenteric Injury Due to Road Traffic Accidents |
title_sort | protective role of obesity on trauma impact: a retrospective analysis of patients with surgical blunt bowel mesenteric injury due to road traffic accidents |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9395217/ https://www.ncbi.nlm.nih.gov/pubmed/36003412 http://dx.doi.org/10.2147/RMHP.S374469 |
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