The impact of body mass index and gender on the development of infectious complications in polytrauma patients

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MICA L. KELLER C. VOMELA Jindřich TRENTZ O. PLECKO M. KEEL M.J.

Rok publikování 2014
Druh Článek v odborném periodiku
Časopis / Zdroj European Journal of Trauma and Emergency Surgery
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Doi http://dx.doi.org/10.1007/s00068-013-0300-8
Obor Chirurgie včetně transplantologie
Klíčová slova body mass index; gender; polytrauma; infection; ISS
Popis Purpose The aim was to test the impact of body mass index (BMI) and gender on infectious complications after polytrauma. Methods: A total of 651 patients were included in this retrospective study, with an Injury Severity Score (ISS) >= 16 and age >= 16 years. The sample was subdivided into three groups: BMI <25 kg/m(2), BMI 25-30 kg/m(2), and BMI >30 kg/m(2), and a female and a male group. Infectious complications were observed for 31 days after admission. Data are given as mean +/- standard errors of the means. Analysis of variance, Kruskal-Wallis test, chi(2) tests, and Pearson's correlation were used for the analyses and the significance level was set at P < 0.05. Results: The overall infection rates were 31.0 % in the BMI < 25 kg/m(2) group, 29.0 % in the BMI 25-30 kg/m(2) group, and 24.5 % in the BMI > 30 kg/m(2) group (P = 0.519). The female patients developed significantly fewer infectious complications than the male patients (26.8 vs. 73.2 %; P < 0.001). The incidence of death was significantly decreased according to the BMI group (8.8 vs. 7.2 vs. 1.5 %; P < 0.0001) and the female population had a significantly lower mortality rate (4.1 vs. 13.4 %; P < 0.0001). Pearson's correlations between the Abbreviated Injury Scale (AIS) score and the corresponding infectious foci were not significant. Conclusion: Higher BMI seems to be protective against polytrauma-associated death but not polytrauma-associated infections, and female gender protects against both polytrauma-associated infections and death. Understanding gender-specific immunomodulation could improve the outcome of polytrauma patients.

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