The aim was to determine the role of obesity in the development of fatal complications and deaths in victims with abdominal trauma. Materials and methods: The study was conducted on the basis of the Department of Polytrauma at the Municipal Health Care Institution of Kharkiv City Council ”O.I. Meshchaninov City Clinical Hospital of Ambulance and Emergency Care”. The authors have analyzed the case histories of 240 patients with abdominal trauma depending on the presence of obesity, which was determined by BMI (body mass index) and/or waist circumference (WC). Results: Complications were found in 93 (38.8%) victims, 34 (14.2%) victims died. It was found that the overall incidence of complications, respiratory and hemocoagulation complications, the incidence of multiple organ failure (MOF) and mortality significantly increased in obese victims. Determination of obesity by the value of the BMI during hospitalization was possible in 41.7% of victims. The identification of WC turned out to be no less informative, but more accessible. Conclusions: Obesity increases the incidence of complications and mortality in victims of abdominal trauma, and is a marker of a negative prognosis. Traditional assessment of BMI during hospitalization in most victims with abdominal trauma is not possible due to the severity of the condition and/or the presence of combined injuries. A good alternative to determining obesity in victims with abdominal trauma is a WC (more than 88 cm in women and more than 102 cm in men).
A literature review deals with the importance of overweight in victims with severe mechanical injury. Mechanical trauma remains an important medical and social problem for humanity. The course of injury and its consequences depend not only on the nature of the trauma, but also on the initial status of victim. The individual characteristics of the patient (gender, age, concomitant somatic pathology, etc.) and the treatment strategy are of great importance, in particular the timing and extent of surgical interventions. In this aspect, the role of overweight, which is a serious health problem worldwide, deserves attention. Many clinical studies and meta-analyses have shown the impact of overweight and obesity on the severity of certain injuries, the course of the post-traumatic period, the frequency of general and local complications, and mortality. Most studies have found that obesity is a marker of a negative prognosis in abdominal injury, and increases the risk of major complications and death. Obesity has been found to be a risk factor for wound complications, intra-abdominal hypertension and abdominal compartment syndrome, acute kidney injury, infectious complications, deep vein thrombosis, thromboembolism and pneumonia. Obese patients who underwent laparotomy for abdominal trauma had higher mortality, longer duration of hospital treatment, and longer duration of stay in the intensive care unit. In addition, obesity impedes interventional manipulations (the placement of the central venous catheter, tracheal intubation, ventilation) and surgical interventions (fracture stabilization, abdominal and thoracic interventions), and reduces the diagnostic value of traditional methods for examination of patients. The negative impact of overweight and obesity should be taken into account when planning diagnostic and treatment strategy, but needs to be further investigated.
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