Abstract
The morbidity and mortality of severely injured patients are commonly affected by multiple factors. Especially, severe chest trauma has been shown to be a significant factor in considering outcome. Contemporaneously, weight-associated endocrinological, haematological, and metabolic deviations from the norm seem to have an impact on the posttraumatic course. Therefore, the aim of this study was to determine the influence of body weight on severely injured patients by emphasizing chest trauma. A total of 338 severely injured patients were included. Multivariate regression analyses were performed on patients with severe chest trauma (AIS ≥ 3) and patients with minor chest trauma (AIS < 3). The influence of body weight on in-hospital mortality was evaluated. Of all the patients, 70.4% were male, the median age was 52 years (IQR 36–68), the overall Injury Severity Score (ISS) was 24 points (IQR 17–29), and a median BMI of 25.1 points (IQR 23–28) was determined. In general, chest trauma was associated with prolonged ventilation, prolonged ICU treatment, and increased mortality. For overweight patients with severe chest trauma, an independent survival benefit was found (OR 0.158; p = 0.037). Overweight seems to have an impact on the mortality of severely injured patients with combined chest trauma. Potentially, a nutritive advantage or still-unknown immunological aspects in these patients affecting the intensive treatment course could be argued.
Highlights
Trauma is known to be a leading public health concern, with approximately 16,000 deaths worldwide due to various injuries each day [1]
Severe chest trauma has been shown to be a significant factor in considering outcome
Analysing patients with only minor chest trauma, we found a positive correlation between mortality and Glasgow Coma Scale (GCS), Abbreviated Injury Scale (AIS) head, Injury Severity Score (ISS), and age
Summary
Trauma is known to be a leading public health concern, with approximately 16,000 deaths worldwide due to various injuries each day [1]. In Western civilizations, severe trauma is the main cause of death among 15- to 44-year-olds [2]. Severe chest trauma has been identified as one of the most frequent injury patterns, in addition to being a crucial prognostic factor and a leading cause of death after trauma [1]. Recent studies revealed extended periods of mechanical ventilation and length of ICU stay for severely injured patients with thoracic injuries [3]. Severe chest trauma has been shown to be associated with the development of diverse complications (e.g., multiple organ dysfunction syndrome (MODS) and an increase of mortality by approximately 25% considering all trauma-related deaths) [3,4]
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