Abstract
BackgroundThe adverse effects of obesity on the physical health have been extensively studied in the general population, but not in motorcycle riders (includes both drivers and pillions). The aim of this study was to compare injury patterns, injury severities, mortality rates, and in-hospital or intensive care unit (ICU) length of stay (LOS) between obese and normal-weight patients who were hospitalized for the treatment of trauma following motorcycle accidents in a level I trauma center.MethodsDetailed data of 466 obese adult patients with a body mass index (BMI) ≥30 kg/m2 and 2701 normal-weight patients (25 > BMI ≥18.5 kg/m2) who had sustained motorcycle accident-related injuries were retrieved from the Trauma Registry System between January 1, 2009 and December 31, 2013. We used the Pearson’s chi-squared test, Fisher’s exact test, and independent Student’s t-test to analyze differences between the two groups.ResultsCompared to normal-weight motorcycle riders, more obese riders were men and drivers as opposed to pillions. In addition, fewer obese motorcycle riders showed alcohol intoxication. Analyses of the patients’ Abbreviated Injury Scale (AIS) scores revealed that obese motorcycle riders presented with a higher rate of injury to the thorax, but a lower rate of injury to the face than normal-weight patients. In addition, obese motorcycle riders had a 2.7-fold greater incidence of humeral, 1.9-fold greater incidence of pelvic, and 1.5-fold greater incidence of rib fractures. In contrast, normal-weight motorcycle riders sustained a significantly higher rate of maxillary and clavicle fractures. Obese motorcycle riders had a significant longer in-hospital LOS than normal-weight motorcycle riders did (10.6 days vs. 9.5 days, respectively; p = 0.044), with an increase in in-hospital LOS of 0.82 days associated with every 10-unit increase in BMI. No statistically significant differences in Injury Severity Score (ISS), New Injury Severity Score (NISS), Trauma-Injury Severity Score (TRISS), mortality, percentage of patients admitted to the ICU, or LOS in the ICU were found between obese and normal-weight patients.DiscussionNo differences of injury severity, mortality, and LOS in the ICU between obese and normal-weight motorcycle riders in this study may be partly attributed to the motorcycle injuries occur at relatively low velocity, considering that the riding of majority of motorcycles are forbidden on highways in Taiwan and that most traffic accidents occur in relatively crowded streets.ConclusionObese motorcycle riders had different injury characteristics and bodily injury patterns than normal-weight motorcycle riders. Moreover, they had a longer in-hospital LOS; this was particularly true for those with pelvic fractures. However, injury severity and mortality were not significantly different between the two groups.
Highlights
The adverse effects of obesity on the physical health have been extensively studied in the general population, but not in motorcycle riders
Detailed patient information was retrieved from the Trauma Registry System of our institution and included data on age, sex, vital signs at admission, injury mechanism, helmet use, Glasgow Coma Scale (GCS) upon arrival at the emergency department, Abbreviated Injury Scale (AIS) severity score for each body region, ISS, New Injury Severity Score (NISS), Trauma-Injury Severity Score (TRISS), in-hospital length of stay (LOS), LOS in the intensive care unit (ICU), in-hospital mortality, and rates of associated complications
No significant differences between obese and normal-weight motorcycle riders were found for the percentage of patients admitted to the ICU (20.0 % vs. 18.2 %, respectively, p = 0.371) or the LOS in the ICU (7.9 days vs. 7.0 days, respectively; p = 0.311), regardless of injury severity
Summary
The adverse effects of obesity on the physical health have been extensively studied in the general population, but not in motorcycle riders (includes both drivers and pillions). The aim of this study was to compare injury patterns, injury severities, mortality rates, and in-hospital or intensive care unit (ICU) length of stay (LOS) between obese and normal-weight patients who were hospitalized for the treatment of trauma following motorcycle accidents in a level I trauma center. The adverse effects of obesity on the physical health have been extensively studied in the general population. Recent studies have indicated that obese trauma patients are more likely to require mechanical ventilation, develop multiple organ failure, and spend more time in the intensive care unit (ICU) [4]. Whereas two studies showed that obese men had the highest mortality risk among the trauma patients [7, 8], others found no significant difference in mortality between obese and non-obese patients [9, 10], even after emergency surgery [11, 12]
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