P. Patalano1, M. C. Smith2, T. Schwartz4, G. Sugiyama3, V. Roudnitsky4 1New York University School Of Medicine,Surgery,New York, NY, USA 2Vanderbilt University Medical Center,Surgery,Nashville, TN, USA 3North Shore University And Long Island Jewish Medical Center,Surgery,Manhasset, NY, USA 4Kings County Hospital Center,Surgery,Brooklyn, NY, USA
Introduction: Obesity is a public health crisis in the United States, as two thirds of the adult population is overweight or obese. Several studies have demonstrated differences in mortality and length of stay (LOS) according to body mass index (BMI) in blunt trauma, but none have examined this in penetrating trauma. We investigated the association between obesity and overall, as well as ICU LOS following admission for anterior abdominal gunshot wound (GSW).
Methods: We performed a retrospective chart review of all patients admitted from January 1, 2013 to September 1, 2015 to our urban, Level I Trauma Center. Records were extracted from the trauma registry by mechanism of injury. Patients who were dead on arrival and pregnant patients were excluded. Variables required to calculate Trauma and Injury Severity Score (TRISS), demographic information, BMI, and information on hospital course were extracted. The TRISS was used to control for injury severity. Our primary outcome was LOS; secondary outcomes were ICU LOS and mortality.
Results: 148 patients were included of which 45 were obese, 46 overweight, 56 normal weight and 1 underweight. There was no significant difference in ISS between obese and normal weight patients (22.38 vs. 22.91, p=0.775). There was a statistically significant increase in LOS for obese patients (21.4 vs. 13.1 days, p=0.032). There was also an increased ICU LOS in obese patients (11.3 days vs. 5.1 days, p=0.020). Obesity was not associated with increased mortality (6.7 vs. 5.4%, p=0.562).
Conclusion: This data illustrates an association between obesity and increased hospital and ICU LOS in patients admitted with an abdominal GSW. Efforts to curb the epidemics of obesity and violence may lead to a reduced burden on the healthcare system as it relates to this issue. Further prospective studies are warranted to examine specific interventions aimed at decreasing length of stay in patients with obesity.
