Key result
In adult trauma patients with severe sepsis, obesity was not associated with a significantly different risk of mortality compared to normal BMI (OR 0.797; 95% CI 0.59-1.06; P=0.126).
Why the study?
Obese patients with severe sepsis have a lower mortality rate than normal BMI patients, prompting the hypothesis that trauma patients with severe sepsis and obesity would also have decreased mortality risk.
Cohort (n=1,246)
Yes
Odds Ratio: 0.797 (95% CI 0.59–1.06)
p-value: p=0.126
Obesity should not alter mortality risk assessment in trauma sepsis; hypothesis-generating and requires prospective confirmation.
Introduction The prevalence of obesity in the United States is up to 40% in adults. Obese patients with severe sepsis have a lower mortality rate compared with normal body mass index (BMI) patients. We hypothesized that trauma patients with severe sepsis and obese BMI will have a decreased mortality risk in comparison with normal BMI patients. Methods The Trauma Quality Improvement Program (2017) was queried for adult trauma patients with documented BMI and severe sepsis. Patients were grouped based on BMI: non-obese trauma patients (nOTP) BMI <30 kg/m 2 and obese trauma patients (OTP) ≥30 kg/m 2 . A multivariable logistic regression model was used for analysis of mortality. Results From 1246 trauma patients with severe sepsis, 566 (42.4%) were nOTP and 680 (57.6%) were OTP. OTP had increased length of stay (LOS) (19 vs 21 days, P < .001), intensive care unit (ICU) LOS (13 vs 18 days, P < .001) and ventilator days (10 vs 11 days, P < .001). After adjusting for covariates, when compared to normal BMI patients, patients who were overweight (OR 1.11 CI .875-1.41 P = .390), obese (OR .797 CI .59-1.06 P = .126), severely obese (OR .926 CI .63-1.36 P = .696) and morbidly obese (OR 1.448 CI 1.01-2.07 P = .04) all had a similar associated risk for mortality compared to patients with normal BMI. Conclusion In adult trauma patients with severe sepsis, this national analysis demonstrated OTP had increased LOS, ICU LOS, and ventilator days compared to nOTP. However, patients with increasing degrees of obesity had similar associated risk of mortality compared to trauma patients with severe sepsis and a normal BMI.
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Tay-Lasso et al. (2022) conducted a cohort in Severe sepsis in trauma patients (n=1,246). Obesity (BMI ≥30 kg/m2) vs. Normal BMI (<30 kg/m2) was evaluated on Mortality (OR 0.797, 95% CI 0.59-1.06, p=0.126). In adult trauma patients with severe sepsis, obesity was not associated with a significantly different risk of mortality compared to normal BMI (OR 0.797; 95% CI 0.59-1.06; P=0.126).
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