Effects of Body Mass Index on Outcome Measures of the Patients with Penetrating Injuries; A Single Center Experience

Objective: To determine if there was any decrease in measures of injury severity or outcome with obese patients (body mass index greater than or equal to 30 kg/m 2 ) as compared to non-obese patients (body mass index less than 30 kg/m 2 ). Methods: We conducted a retrospective review of the trauma database maintained by Natividad Medical Center's Level 2-Trauma program. From July 1st, 2014 to July 1st, 2017 there were 371 cases of penetrating trauma in adults between the ages of 18-80 years old. Overall 311 patients had BMI data recorded. We divided these 311 patients into two groups: penetrating injury due to firearm (n= 198) and penetrating injury due to stabbing or piercing (n=113). We compared non-obese patients against obese patients for age, gender, Injury Severity Score (ISS), length of stay (LOS), Intensive Care Unit LOS, units of blood given, direct transfer from ED to operating room, and mortality. Results: A total of 311 patients were included in the study, 198 (63.6%) patients suffered from gunshot wounds and 113 (36.4) from stab or piercing wounds. The mean age was 33.6 ± 12.8 and there were 283 (91%) men among the victims. Overall 87 (28%) required emergent surgery and a 19 (6.1%) mortality rate was recorded. In the gunshot wound group there was no significant difference between non-obese and obese patients for age ( p =0.400), gender ( p =0.900), ISS ( p =0.544), LOS ( p =0.273), Intensive Care Unit LOS ( p =0.729), units of blood given ( p =0.300), or mortality ( p =0.855). We found that in the stab or piercing group there was no significant difference between non-obese and obese patients for age (p=0.900), gender ( p =0.900), ISS ( p =0.580), LOS ( p =0.839), Intensive Care Unit LOS ( p =0.305), units of blood given ( p =0.431), or mortality ( p =0.321). Conclusion: Our findings indicate that in our patient population, there was no significant difference in markers of injury severity, morbidity, or mortality in adult non-obese patients as comparted with obese patients.  Furthermore, there was no significant difference between the two groups in operative rates, suggesting that obesity may not confer a protective effect in penetrating trauma.