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Injury. 2014 Jan;45(1):253-8. doi: 10.1016/j.injury.2012.11.015. Epub 2012 Dec 20.

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

Author information

1
Division of Trauma Surgery, University Hospital of Zürich, Switzerland. Electronic address: ladislav.mica@usz.ch.

Abstract

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 χ(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.

KEYWORDS:

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

PMID:
23260868
DOI:
10.1016/j.injury.2012.11.015
[Indexed for MEDLINE]

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