Angel L. Torres-Rivera MD, Presenter: Nothing to Disclose

Felipe Munera MD, Abstract Co-Author: Nothing to Disclose

Courtnay Bloomer MD, Abstract Co-Author: Nothing to Disclose

Alejandro Zuluaga MD, Abstract Co-Author: Nothing to Disclose

Obesity is an ever worsening epidemic in the U.S. Current literature has shown that body mass index (BMI) is proportional to severity of injury in the setting of blunt trauma but demonstrate different injury patterns than those of normal weight. Obese patients have higher morbidity associated with comparable injuries. We sought to investigate if there are generalized patterns of injury in obese patients that may help explain the increased morbidity and guide clinical care.

Jackson Memorial Hospital Institutional Review Board approval was obtained. An ongoing, retrospective study of 65 (15 female) consecutive patients admitted through a level 1, urban trauma center who underwent abdominal/pelvic CT for the indication of blunt trauma from February to May 2007. Patients younger than 18 years of age or pregnant women were excluded. Images were interpreted retrospectively by a board certified radiologist with subspeciality training in trauma, and two radiology residents. Using a previously validated the BMI (Body Mass Index) was estimated based on CT measurements the patients were assigned to by BMI above >30 (Obese group) or <30 (Normal weight group). Injuries were standardized and quantified into 5 patterns.

Twenty-three patients incurred injury, 8 were assigned to the obese group. Thirteen injuries were identified in the obese group. We calculated an odds ratio 3.94 of an obese patient having an injury compared to normal weight but had decreased severity of injuries for equivalent mechanisms of trauma. The distribution of injuries was independent of gender.

Obese patients demonstrate increased number of less severe injuries than those of normal weight. As obese patients have higher morbidity in the setting of blunt trauma, knowledge of injury patterns is necessary for early intervention to decrease morbidity and mortality.

Obese patients sustain increased number of less severe injuries for equivalent levels of trauma but have higher associated morbidity; awareness of injury patterns can help guide critical care.

Torres-Rivera, A, Munera, F, Bloomer, C, Zuluaga, A, Evaluation of Abdominal Blunt Trauma Patterns in Obese Patients Using Multidetector CT.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6014876.html