ArticleWorld journal of surgery2020
The Obesity Paradox in the Trauma Patient: Normal May not Be Better.
Article in World journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Hallmarks of the multidimensional immune response to trauma in humans.Nature immunology · 2026Review
- Electric bicycle versus conventional bicycle crashes: comparative analysis of injury patterns, severity, and the modifying effect of body mass index.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- BMI is independently associated with ARDS, sepsis and multiorgan failure after major trauma-results of a high-volume retrospective observational cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Observational
- The Influence of BMI on Mortality and Clinical Outcomes After Burns.European burn journal · 2026Article
- Development of a nomogram to predict in-hospital mortality of trauma patients in the ICU: an analysis of the MIMIC-IV database.Scientific reports · 2026Article
- Obesity significantly elevates thromboembolism risk in severe trauma, yet essential resuscitation with TXA and erythrocytes remains safe.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Is obesity a protective factor in pediatric trauma? A retrospective review in a tertiary trauma centre over the decade.Pediatric surgery international · 2025Article
- Patterns of sex-specific outcomes and mortality in polytrauma: a demographic and epidemiologic analysis by injury severity score.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Observational
- Obesity influences the biological response to injury: a multi-omics analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Association Between Obesity and Intra-Abdominal Solid Organ Damage in Patients with Blunt Abdominal Trauma: A Cross-Sectional Study.Journal of clinical medicine · 2024Article
- An evaluation of the "Obesity Paradox" in isolated blunt abdominal trauma in the United States.Injury · 2024Article
- Obesity and Penetrating Trauma: Outcomes from a Level 1 Trauma Center in New York City.Open access emergency medicine : OAEM · 2024Article
- The association of radiologic body composition parameters with clinical outcomes in level-1 trauma patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Obese adolescents have higher risk for severe lower extremity fractures after falling.Pediatric surgery international · 2023Article
- Blood Count-Derived Inflammatory Markers Correlate with Lengthier Hospital Stay and Are Predictors of Pneumothorax Risk in Thoracic Trauma Patients.Diagnostics (Basel, Switzerland) · 2023Article
- High Fat-to-Muscle Ratio Was Associated with Increased Clinical Severity in Patients with Abdominal Trauma.Journal of clinical medicine · 2023Article
- Adipose tissue: a neglected organ in the response to severe trauma?Cellular and molecular life sciences : CMLS · 2022Review
- Protective Role of Obesity on Trauma Impact: A Retrospective Analysis of Patients with Surgical Blunt Bowel Mesenteric Injury Due to Road Traffic Accidents.Risk management and healthcare policy · 2022Article
- The Impact of Obesity on Renal Trauma Outcome: An Analysis of the National Trauma Data Bank from 2013 to 2016.World journal of surgery · 2021Article
- Emergencies in obese patients: a narrative review.Journal of anesthesia, analgesia and critical care · 2021Review
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe obesity paradox is the association of increased survival for overweight and obese patients compared to normal and underweight patients, despite an increased risk of morbidity. The obesity paradox has been demonstrated in many disease states but has yet to be studied in trauma. The objective of this study is to elucidate the presence of the obesity paradox in trauma patients by evaluating the association between BMI and outcomes.
methodsUsing the 2014-2015 National Trauma Database (NTDB), adults were categorized by WHO BMI category. Logistic regression was used to assess the odds of mortality associated with each category, adjusting for statistically significant covariables. Length of stay (LOS), ICU LOS and ventilator days were also analyzed, adjusting for statistically significant covariables.
resultsA total of 415,807 patients were identified. Underweight patients had increased odds of mortality (OR 1.378, p < 0.001 95% CI 1.252-1.514), while being overweight had a protective effect (OR 0.916, p = 0.002 95% CI 0.867-0.968). Class I obesity was not associated with increased mortality compared to normal weight (OR 1.013, p = 0.707 95% CI 0.946-1.085). Class II and Class III obesity were associated with increased mortality risk (Class II OR 1.178, p = 0.001 95% CI 1.069-1.299; Class III OR 1.515, p < 0.001 95% CI 1.368-1.677). Hospital and ICU LOS increased with each successive increase in BMI category above normal weight. Obesity was associated with increased ventilator days; Class I obese patients had a 22% increase in ventilator days (IRR 1.217 95% CI 1.171-1.263), and Class III obese patients had a 54% increase (IRR 1.536 95% CI 1.450-1.627).
conclusionThe obesity paradox exists in trauma patients. Further investigation is needed to elucidate what specific phenotypic aspects confer this benefit and how these can enhance patient care. LEVEL OF EVIDENCE: Level III, prognostic study.
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