Obesity is Associated with Worse Outcomes Among Abdominal Trauma Patients Undergoing Laparotomy: A Propensity-Matched Nationwide Cohort Study
Introduction Obesity is associated with increased morbidity and mortality in abdominal trauma patients. The characteristics of abdominal trauma patients with poor outcomes related to obesity require evaluation. We hypothesize that obesity is related to increased mortality and length of stay (LOS) am...
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| Veröffentlicht in: | World journal of surgery 2020-03, Vol.44 (3), p.755-763 |
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| creator | Fu, Chih-Yuan Bajani, Francesco Bokhari, Marissa Tatebe, Leah C. Starr, Frederick Messer, Thomas Kaminsky, Matthew Dennis, Andrew Schlanser, Victoria Mis, Justin Toor, Rubinder Poulakidas, Stathis Bokhari, Faran |
| description | Introduction
Obesity is associated with increased morbidity and mortality in abdominal trauma patients. The characteristics of abdominal trauma patients with poor outcomes related to obesity require evaluation. We hypothesize that obesity is related to increased mortality and length of stay (LOS) among abdominal trauma patients undergoing laparotomies.
Methods
Abdominal trauma patients were identified from the National Trauma Data Bank between 2013 and 2015. Patients who received laparotomies were analyzed using propensity score matching (PSM) to evaluate the mortality rate and LOS between obese and non-obese patients. Patients without laparotomies were analyzed as a control group using PSM cohort analysis.
Results
A total of 33,798 abdominal trauma patients were evaluated, 10,987 of them received laparotomies. Of these patients, the proportion of obesity in deceased patients was significantly higher when compared to the survivors (33.1% vs. 26.2%,
p |
| doi_str_mv | 10.1007/s00268-019-05268-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7223826</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2314010690</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5254-da165a04e881b434c461492cac439829ed53b32a1d05e4e2b5f30d0a19f782e13</originalsourceid><addsrcrecordid>eNqNkctuEzEUhi0EoqHwAiyQJTZshvo6ly6QQkShKJBKbdWl5fGcJK5mxsH2EM1D8M54SCmXBWLlI5_v_318foSeU_KaElKcBEJYXmaEVhmRUyUfoBkVnGWMM_4QzQjPRaopP0JPQrglhBY5yR-jI04LykqRz9C3VQ3BxhHbgOchOGN1hAbvbdziG-cD4NUQjesgtTvXb_C8blxne93iK6-HTuMLHS30MeDrvgG_cTZBS73T3kXXjad4ji-820E_vZJ90tFsk__nJHL93jaAF27rfMSXcWjGp-jRWrcBnt2dx-j67N3V4kO2XL0_X8yXmZFMiqzRNJeaCChLWgsujMipqJjRRvCqZBU0ktecadoQCQJYLdecNETTal2UDCg_Rm8Ovruh7qAxaX6vW7XzttN-VE5b9Went1u1cV9VwRgvWZ4MXt0ZePdlgBBVZ4OBttU9uCGotHRBKMkrktCXf6G3bvBpgRMlC0aKUspEsQNlvAvBw_p-GErUlLY6pK1S2upH2moSvfj9G_eSn_Em4PQA7G0L439YqpuPl2_P0nUlkpgfxCHp-g34X4P_Y6bvsFbIhA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2357207855</pqid></control><display><type>article</type><title>Obesity is Associated with Worse Outcomes Among Abdominal Trauma Patients Undergoing Laparotomy: A Propensity-Matched Nationwide Cohort Study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Springer Nature - Complete Springer Journals</source><creator>Fu, Chih-Yuan ; Bajani, Francesco ; Bokhari, Marissa ; Tatebe, Leah C. ; Starr, Frederick ; Messer, Thomas ; Kaminsky, Matthew ; Dennis, Andrew ; Schlanser, Victoria ; Mis, Justin ; Toor, Rubinder ; Poulakidas, Stathis ; Bokhari, Faran</creator><creatorcontrib>Fu, Chih-Yuan ; Bajani, Francesco ; Bokhari, Marissa ; Tatebe, Leah C. ; Starr, Frederick ; Messer, Thomas ; Kaminsky, Matthew ; Dennis, Andrew ; Schlanser, Victoria ; Mis, Justin ; Toor, Rubinder ; Poulakidas, Stathis ; Bokhari, Faran</creatorcontrib><description>Introduction
Obesity is associated with increased morbidity and mortality in abdominal trauma patients. The characteristics of abdominal trauma patients with poor outcomes related to obesity require evaluation. We hypothesize that obesity is related to increased mortality and length of stay (LOS) among abdominal trauma patients undergoing laparotomies.
Methods
Abdominal trauma patients were identified from the National Trauma Data Bank between 2013 and 2015. Patients who received laparotomies were analyzed using propensity score matching (PSM) to evaluate the mortality rate and LOS between obese and non-obese patients. Patients without laparotomies were analyzed as a control group using PSM cohort analysis.
Results
A total of 33,798 abdominal trauma patients were evaluated, 10,987 of them received laparotomies. Of these patients, the proportion of obesity in deceased patients was significantly higher when compared to the survivors (33.1% vs. 26.2%,
p
< 0.001). Elevation of one kg/m
2
of body mass index independently resulted in 2.5% increased odds of mortality. After a well-balanced PSM, obese patients undergoing laparotomies had significantly higher mortality rates [3.7% vs. 2.4%, standardized difference (SD) = 0.241], longer hospital LOS (11.1 vs. 9.6 days, SD = 0.135), and longer intensive care unit LOS (3.5 vs. 2.3 days, SD = 0.171) than non-obese patients undergoing laparotomies.
Conclusions
Obesity is associated with increased mortality in abdominal trauma patients who received laparotomies versus those who did not. Obesity requires a careful evaluation of alternatives to laparotomy in injured patients.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-019-05268-5</identifier><identifier>PMID: 31712846</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdomen ; Abdominal Injuries - surgery ; Abdominal Surgery ; Adult ; Body mass ; Body mass index ; Body size ; Cardiac Surgery ; Cohort analysis ; Cohort Studies ; Female ; General Surgery ; Humans ; Identification methods ; Laparotomy - mortality ; Length of Stay ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Morbidity ; Mortality ; Obesity ; Obesity - complications ; Original Scientific Report ; Propensity Score ; Surgery ; Thoracic Surgery ; Trauma ; Trauma centers ; Vascular Surgery</subject><ispartof>World journal of surgery, 2020-03, Vol.44 (3), p.755-763</ispartof><rights>Société Internationale de Chirurgie 2019</rights><rights>2020 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>World Journal of Surgery is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5254-da165a04e881b434c461492cac439829ed53b32a1d05e4e2b5f30d0a19f782e13</citedby><cites>FETCH-LOGICAL-c5254-da165a04e881b434c461492cac439829ed53b32a1d05e4e2b5f30d0a19f782e13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-019-05268-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-019-05268-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,778,782,883,1414,27911,27912,41475,42544,45561,45562,51306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31712846$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fu, Chih-Yuan</creatorcontrib><creatorcontrib>Bajani, Francesco</creatorcontrib><creatorcontrib>Bokhari, Marissa</creatorcontrib><creatorcontrib>Tatebe, Leah C.</creatorcontrib><creatorcontrib>Starr, Frederick</creatorcontrib><creatorcontrib>Messer, Thomas</creatorcontrib><creatorcontrib>Kaminsky, Matthew</creatorcontrib><creatorcontrib>Dennis, Andrew</creatorcontrib><creatorcontrib>Schlanser, Victoria</creatorcontrib><creatorcontrib>Mis, Justin</creatorcontrib><creatorcontrib>Toor, Rubinder</creatorcontrib><creatorcontrib>Poulakidas, Stathis</creatorcontrib><creatorcontrib>Bokhari, Faran</creatorcontrib><title>Obesity is Associated with Worse Outcomes Among Abdominal Trauma Patients Undergoing Laparotomy: A Propensity-Matched Nationwide Cohort Study</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Introduction
Obesity is associated with increased morbidity and mortality in abdominal trauma patients. The characteristics of abdominal trauma patients with poor outcomes related to obesity require evaluation. We hypothesize that obesity is related to increased mortality and length of stay (LOS) among abdominal trauma patients undergoing laparotomies.
Methods
Abdominal trauma patients were identified from the National Trauma Data Bank between 2013 and 2015. Patients who received laparotomies were analyzed using propensity score matching (PSM) to evaluate the mortality rate and LOS between obese and non-obese patients. Patients without laparotomies were analyzed as a control group using PSM cohort analysis.
Results
A total of 33,798 abdominal trauma patients were evaluated, 10,987 of them received laparotomies. Of these patients, the proportion of obesity in deceased patients was significantly higher when compared to the survivors (33.1% vs. 26.2%,
p
< 0.001). Elevation of one kg/m
2
of body mass index independently resulted in 2.5% increased odds of mortality. After a well-balanced PSM, obese patients undergoing laparotomies had significantly higher mortality rates [3.7% vs. 2.4%, standardized difference (SD) = 0.241], longer hospital LOS (11.1 vs. 9.6 days, SD = 0.135), and longer intensive care unit LOS (3.5 vs. 2.3 days, SD = 0.171) than non-obese patients undergoing laparotomies.
Conclusions
Obesity is associated with increased mortality in abdominal trauma patients who received laparotomies versus those who did not. Obesity requires a careful evaluation of alternatives to laparotomy in injured patients.</description><subject>Abdomen</subject><subject>Abdominal Injuries - surgery</subject><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Cardiac Surgery</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Identification methods</subject><subject>Laparotomy - mortality</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Original Scientific Report</subject><subject>Propensity Score</subject><subject>Surgery</subject><subject>Thoracic Surgery</subject><subject>Trauma</subject><subject>Trauma centers</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkctuEzEUhi0EoqHwAiyQJTZshvo6ly6QQkShKJBKbdWl5fGcJK5mxsH2EM1D8M54SCmXBWLlI5_v_318foSeU_KaElKcBEJYXmaEVhmRUyUfoBkVnGWMM_4QzQjPRaopP0JPQrglhBY5yR-jI04LykqRz9C3VQ3BxhHbgOchOGN1hAbvbdziG-cD4NUQjesgtTvXb_C8blxne93iK6-HTuMLHS30MeDrvgG_cTZBS73T3kXXjad4ji-820E_vZJ90tFsk__nJHL93jaAF27rfMSXcWjGp-jRWrcBnt2dx-j67N3V4kO2XL0_X8yXmZFMiqzRNJeaCChLWgsujMipqJjRRvCqZBU0ktecadoQCQJYLdecNETTal2UDCg_Rm8Ovruh7qAxaX6vW7XzttN-VE5b9Went1u1cV9VwRgvWZ4MXt0ZePdlgBBVZ4OBttU9uCGotHRBKMkrktCXf6G3bvBpgRMlC0aKUspEsQNlvAvBw_p-GErUlLY6pK1S2upH2moSvfj9G_eSn_Em4PQA7G0L439YqpuPl2_P0nUlkpgfxCHp-g34X4P_Y6bvsFbIhA</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Fu, Chih-Yuan</creator><creator>Bajani, Francesco</creator><creator>Bokhari, Marissa</creator><creator>Tatebe, Leah C.</creator><creator>Starr, Frederick</creator><creator>Messer, Thomas</creator><creator>Kaminsky, Matthew</creator><creator>Dennis, Andrew</creator><creator>Schlanser, Victoria</creator><creator>Mis, Justin</creator><creator>Toor, Rubinder</creator><creator>Poulakidas, Stathis</creator><creator>Bokhari, Faran</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202003</creationdate><title>Obesity is Associated with Worse Outcomes Among Abdominal Trauma Patients Undergoing Laparotomy: A Propensity-Matched Nationwide Cohort Study</title><author>Fu, Chih-Yuan ; Bajani, Francesco ; Bokhari, Marissa ; Tatebe, Leah C. ; Starr, Frederick ; Messer, Thomas ; Kaminsky, Matthew ; Dennis, Andrew ; Schlanser, Victoria ; Mis, Justin ; Toor, Rubinder ; Poulakidas, Stathis ; Bokhari, Faran</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5254-da165a04e881b434c461492cac439829ed53b32a1d05e4e2b5f30d0a19f782e13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdomen</topic><topic>Abdominal Injuries - surgery</topic><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Cardiac Surgery</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Identification methods</topic><topic>Laparotomy - mortality</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Original Scientific Report</topic><topic>Propensity Score</topic><topic>Surgery</topic><topic>Thoracic Surgery</topic><topic>Trauma</topic><topic>Trauma centers</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fu, Chih-Yuan</creatorcontrib><creatorcontrib>Bajani, Francesco</creatorcontrib><creatorcontrib>Bokhari, Marissa</creatorcontrib><creatorcontrib>Tatebe, Leah C.</creatorcontrib><creatorcontrib>Starr, Frederick</creatorcontrib><creatorcontrib>Messer, Thomas</creatorcontrib><creatorcontrib>Kaminsky, Matthew</creatorcontrib><creatorcontrib>Dennis, Andrew</creatorcontrib><creatorcontrib>Schlanser, Victoria</creatorcontrib><creatorcontrib>Mis, Justin</creatorcontrib><creatorcontrib>Toor, Rubinder</creatorcontrib><creatorcontrib>Poulakidas, Stathis</creatorcontrib><creatorcontrib>Bokhari, Faran</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fu, Chih-Yuan</au><au>Bajani, Francesco</au><au>Bokhari, Marissa</au><au>Tatebe, Leah C.</au><au>Starr, Frederick</au><au>Messer, Thomas</au><au>Kaminsky, Matthew</au><au>Dennis, Andrew</au><au>Schlanser, Victoria</au><au>Mis, Justin</au><au>Toor, Rubinder</au><au>Poulakidas, Stathis</au><au>Bokhari, Faran</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Obesity is Associated with Worse Outcomes Among Abdominal Trauma Patients Undergoing Laparotomy: A Propensity-Matched Nationwide Cohort Study</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2020-03</date><risdate>2020</risdate><volume>44</volume><issue>3</issue><spage>755</spage><epage>763</epage><pages>755-763</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Introduction
Obesity is associated with increased morbidity and mortality in abdominal trauma patients. The characteristics of abdominal trauma patients with poor outcomes related to obesity require evaluation. We hypothesize that obesity is related to increased mortality and length of stay (LOS) among abdominal trauma patients undergoing laparotomies.
Methods
Abdominal trauma patients were identified from the National Trauma Data Bank between 2013 and 2015. Patients who received laparotomies were analyzed using propensity score matching (PSM) to evaluate the mortality rate and LOS between obese and non-obese patients. Patients without laparotomies were analyzed as a control group using PSM cohort analysis.
Results
A total of 33,798 abdominal trauma patients were evaluated, 10,987 of them received laparotomies. Of these patients, the proportion of obesity in deceased patients was significantly higher when compared to the survivors (33.1% vs. 26.2%,
p
< 0.001). Elevation of one kg/m
2
of body mass index independently resulted in 2.5% increased odds of mortality. After a well-balanced PSM, obese patients undergoing laparotomies had significantly higher mortality rates [3.7% vs. 2.4%, standardized difference (SD) = 0.241], longer hospital LOS (11.1 vs. 9.6 days, SD = 0.135), and longer intensive care unit LOS (3.5 vs. 2.3 days, SD = 0.171) than non-obese patients undergoing laparotomies.
Conclusions
Obesity is associated with increased mortality in abdominal trauma patients who received laparotomies versus those who did not. Obesity requires a careful evaluation of alternatives to laparotomy in injured patients.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>31712846</pmid><doi>10.1007/s00268-019-05268-5</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0364-2313 |
| ispartof | World journal of surgery, 2020-03, Vol.44 (3), p.755-763 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Springer Nature - Complete Springer Journals |
| subjects | Abdomen Abdominal Injuries - surgery Abdominal Surgery Adult Body mass Body mass index Body size Cardiac Surgery Cohort analysis Cohort Studies Female General Surgery Humans Identification methods Laparotomy - mortality Length of Stay Male Medicine Medicine & Public Health Middle Aged Morbidity Mortality Obesity Obesity - complications Original Scientific Report Propensity Score Surgery Thoracic Surgery Trauma Trauma centers Vascular Surgery |
| title | Obesity is Associated with Worse Outcomes Among Abdominal Trauma Patients Undergoing Laparotomy: A Propensity-Matched Nationwide Cohort Study |
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