Obesity makes surgery more difficult and risky

Critically injured obese trauma patients have higher rates of death than non-obese trauma patients, according to an article in the September issue of The Archives of Surgery, one of the JAMA/Archives journals.

According to the article, 18.9 percent of the U.S. population is obese, defined as a body mass index (BMI) of 30 or higher. Obesity can interfere with the body's response to injury – obese patients have reduced lung capacity and a higher incidence of cardiovascular disease. Obesity also makes surgery more difficult and risky, and radiographic images less reliable, the article states.

Angela L. Neville, M.D., of Los Angeles County and University of Southern California Medical Center, Los Angeles, and colleagues investigated the relationship between obesity and outcomes for blunt trauma patients.

The researchers looked at 242 consecutive patients admitted to the intensive care unit following blunt trauma at a Level 1 trauma center between January 2002 and December 2002. Patients were divided into two groups according to BMI. The obese group had a BMI of 30 or higher, and the nonobese group had a BMI lower than 30.

The researchers found that of the 242 patients, 63 (26 percent) were obese. Both groups were similar in age, and degree of injury severity. The researchers write that "The obese group had a higher incidence of multiple organ failure (13 percent vs. 3 percent) and mortality (32 percent vs. 16 percent)." The overall death rate among study participants was 20 percent.

"Obesity, as an independent risk factor, carries a nearly six-fold increase in mortality rate," the authors conclude.

http://www.jama.com/