Impact of body mass index on injury in abdominal stab wounds: implications for management

Bloom, Matthew B.; Ley, Eric J.; Liou, Douglas Z.; Tran, Tri M.; Chung, Rex; Melo, Natália; Margulies, Daniel R.

doi:10.1016/j.jss.2015.03.052

Cited by 26 publications

(51 citation statements)

References 16 publications

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“…(10) Compared to other cohort studies investigating stab wound injuries, our study is similar in terms of injury severity. A 12-year study of abdominal stab wound injuries at Cedars-Sinai Medical Center in Los Angeles, California, (11) found that of 249 stab wound injuries, the mean ISS was 11.1 ± 7.9, similar to that of the current study (11.8 ± 8.0). The use of CT was 35.0%, which is comparable to that in the current study (34.2%), and the operative rate was 83.3% vs. 85.2% in our study, suggesting that our trauma centre has similar practice patterns to an urban Level 1 trauma centre in the US.…”

Section: Discussionsupporting

confidence: 84%

A review of stab wound injuries at a tertiary trauma centre in Singapore: are self-inflicted ones less severe

Leow

Lingam

Lim

et al. 2016

smedj

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, MBBS, FAMS INTRODUCTION In Singapore, as strict laws are a strong deterrent against armed violence, little is known about the epidemiology of penetrating stab wound injuries. Our study aimed to investigate the epidemiology of stab wound injuries at a major trauma centre in Singapore and determine if there was a difference in severity between self-inflicted stab wound (SI) injuries and those inflicted by others (IO). METHODSWe retrospectively reviewed all penetrating injuries at Tan Tock Seng Hospital, and identified and categorised all stab wound injuries as SI or IO. Basic demographic information, injury severity characteristics and outcome data were compared between these two groups. A review of all mortalities was performed, including recording the causes of death.RESULTS Between 2005 and 2010, there were a total of 149 stab wound injuries, of which 24 (16.1%) were SI and 125 (83.9%) were IO injuries. Patients tended to be young (mean age 34.1 ± 14.2 years). The mean Injury Severity Score was significantly different between the SI and IO groups (8.8 ± 6.5 vs. 12.3 ± 8.1; p = 0.03). In both groups, the majority underwent an operative procedure (83.3% vs. 85.6%) and had an average hospital stay of four days. CONCLUSIONThe study confirms our hypothesis that SI injuries tend to be less severe than IO injuries and are more likely to occur at home rather than at a public area. This finding may be useful in the triage of patients with stab wound injuries.

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Section: Discussionsupporting

confidence: 84%

A review of stab wound injuries at a tertiary trauma centre in Singapore: are self-inflicted ones less severe

Leow

Lingam

Lim

et al. 2016

smedj

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“…In the United States, the obesity rate has continued to increase over the last twenty years resulting in a national epidemic [1,2]. From 2011 to 2012, 35% of adults in the United States met criteria to be considered obese [3].…”

Section: Introductionmentioning

confidence: 99%

“…While there are mixed results regarding the effects of obesity and complications following trauma, there is literature that suggests obesity is an independent risk factor for infection and pneumonia [2]. One such study found that morbidly obese trauma patients had increased odds of post-operative complications including pneumonia and urinary tract infection (UTI) compared to patients with a normal BMI [4].…”

Section: Introductionmentioning

confidence: 99%

Infectious complications in obese patients after trauma

Bell

Bayt

Siedlecki

et al. 2016

Journal of Surgical Research

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Background: Obesity is a public health concern in the U.S. due to its increasing prevalence, especially in younger age groups. Trauma is the most common cause of death for people under 40 years of age. The purpose of this study is to determine the association between obesity and specific infectious complications following traumatic injury. Materials and Methods:A retrospective analysis was conducted using data from the 2012 National Trauma Data Bank (NTDB). The NTDB defined obesity as having a BMI of 30 or greater. Descriptive statistics were calculated and stratified by obesity status. A hierarchical regression model was used to determine the odds of experiencing an infectious complication in patients with obesity while controlling for age, gender, diabetes, number of comorbidities, injury severity, injury mechanism, head injury, and surgical procedure. Results:Patients with a BMI of 30 or greater compared to non-obese patients had increased odds of having an infectious complication (OR=1.59, 1.49-1.69). In addition to obesity, ISS greater than 29, age 40 years or older, diabetes, comorbid conditions, and having a surgical procedure were also predictive of an infectious complication. Conclusions:Our results indicate that trauma patients with obesity are nearly 60% more likely to develop an infectious complication in the hospital. Infection prevention and control measures should be implemented soon after hospital arrival for patients with obesity, particularly those with operative trauma.

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“…It is alleged that a 44‐year‐old man survived 38 stab injuries because of his obesity . Historically gladiators in ancient Rome were thought to have purposely engaged in eating high calorie diets to increase their subcutaneous fat, believing that the extra layer would be protective against stab wounds in combat . This would not, however, explain the lower rates of blunt force and firearm homicides in the morbidly obese population.…”

Section: Discussionmentioning

confidence: 99%

Obesity, Body Mass Index, and Homicide

Omond

Langlois

Byard

2016

Journal of Forensic Sciences

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The body mass indexes (BMIs) of 100 randomly selected homicide cases from the files of Forensic Science SA were compared to the Australian and South Australian populations. There were 70 males and 30 females (M:F = 2.3:1; age range 18-84 years; mean 42.3 years). There was a substantially lower proportion of obese individuals in the homicide population compared to the general Australian and South Australian populations (19% [vs.] 27.9% and 30%, respectively). A second group of 144 randomly selected autopsy cases where the BMI was ≥40 kg/m was analyzed. There were 77 males and 67 females (M:F = 1.2:1; age range 23-78 years; mean 46.7 years). The majority of deaths were natural (N = 108), with no homicides. A negative association between obesity and homicide has, therefore, been demonstrated. Reasons for the lower numbers of obese/morbidly obese individuals among homicide victims are unclear, but may include physical protection afforded by fat padding from sharp force injuries, and relative sociodemographic isolation.

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Impact of body mass index on injury in abdominal stab wounds: implications for management

Cited by 26 publications

References 16 publications

A review of stab wound injuries at a tertiary trauma centre in Singapore: are self-inflicted ones less severe

A review of stab wound injuries at a tertiary trauma centre in Singapore: are self-inflicted ones less severe

Infectious complications in obese patients after trauma

Obesity, Body Mass Index, and Homicide

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