Abstract
451 patients had PAI and were grouped by BMI of ≥ 30 (OBESE) or < 30 (NON-OBESE). 381 patients with abdominal obesity were included. 79 (21%) were OBESE and 302 (79%) were NON-OBESE. 68% of the OBESE underwent laparotomy vs. 57% of the NON-OBESE (p = 0.06). Of the OBESE undergoing surgery, 48% were therapeutic laparotomies. Of the NON-OBESE, 65% had therapeutic laparotomies (p = 0.041). 9% of the OBESE had liver injuries vs. 30% of the NON-OBESE. (p = 0.003) 21% of the OBESE had vascular injuries vs. 5% for the NON-OBESE (p = 0.007). There were no significant differences in rates of diaphragmatic, gastric, spleen, renal, small bowel, or colon injuries. There was a total of one death on arrival for patient with BMI below 30.
Highlights
In 1960, Shaftan, et al recognized that mandatory laparotomy for penetrating abdominal injury (PAI) resulted in negative findings in approximately one-third of patients, with significant associated morbidity and mortality [1]
This study is the first to examine the correlation between PAI and Body Mass Index (BMI) for results of laparotomy
OBESE patients have a higher rate of laparotomy and undergo more non-therapeutic operations
Summary
In 1960, Shaftan, et al recognized that mandatory laparotomy for penetrating abdominal injury (PAI) resulted in negative findings in approximately one-third of patients, with significant associated morbidity and mortality [1]. This was underlined by a 37 percent negative laparotomy rate after mandatory laparotomy for truncal stab wounds. Et al, in a retrospective study correlated the BMI with severity of injury in patients involved in motor vehicle accidents and found combination of BMI above 30 and seat belt use increases the odds of abdominal injury by 2.5-fold, there was no correlation between BMI above 30 with seat belts and increased intra-abdominal injury [2].
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