Obesity as a Risk Factor for Nosocomial Infections in Trauma Patients

Serrano, Pablo E.; Khuder, Sadik A.; Fath, John J.

doi:10.1016/j.jamcollsurg.2010.03.002

Cited by 91 publications

(58 citation statements)

References 52 publications

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“…In the ICU population 61% of obese patients had infections compared to 34% in the non-obese group [1]. Another study found that obesity was a predictor of nosocomial infections in trauma patients with an OR=4.69 [14]. Our findings add to this literature by examining the association of obesity and individual infectious complications following traumatic injury using a large national sample from multiple institutions.…”

Section: Discussionmentioning

confidence: 57%

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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Section: Discussionmentioning

confidence: 57%

Infectious complications in obese patients after trauma

Bell

Bayt

Siedlecki

et al. 2016

Journal of Surgical Research

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“…BMI stratifications were grouped into 3 categories on the basis of previous research for multivariate analysis: nonobese, 3,[8][9][10]12,15,19,22,26 obese, and morbidly obese. 17,25,27,44 Analyses were completed on each weight classification. Statistical significance was set at P < .05.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have indicated that obese trauma patients are more likely than nonobese patients to have longer stays in the intensive care unit (ICU) 7,[9][10][11] and hospital, 9,11-13 more days of mechanical ventilation, 7,14 more complications 7,9,[15][16][17][18] and comorbid conditions, 16 and higher mortality. 7,16,[18][19][20][21][22] Other studies have indicated no differences between obese and nonobese patients in mortality, 10,11,17,[23][24][25][26] length of stay in the ICU 13,27 and the hospital, 20,22,26 duration of mechanical ventilation, 11,13,27 complications, 11,22,24,26 or comorbid conditions. 3 Care of critically ill trauma patients is resource intensive, technically involved, and expensive because of the need for highly trained staff and modern equipment and the use of diagnostic tests, pharmaceutical agents, and interventions.…”

mentioning

confidence: 99%

“…29 In previous research on the effect of a patient's BMI on resource usage, each usage outcome was assessed independently of other resource usage variables. In those studies, 3,7,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]30 resource usage was evaluated as a secondary outcome by using familiar statistical analyses (t test, analysis of variance, regression analysis) suitable for the research questions. However, in order to best ascertain the association between the complex, multifaceted relationship of patient/ injury characteristics and hospital resource usage, the use of multivariate canonical correlation analyses is suggested.…”

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confidence: 99%

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Association of Injury Factors, Not Body Mass Index, With Hospital Resource Usage in Trauma Patients

Lee

Hervey

Berg

et al. 2016

American Journal of Critical Care

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Background Allocating resources appropriately requires knowing whether obese patients use more resources during a hospital stay than nonobese patients. Objectives To determine if trauma patients with different body mass indexes differed in use of resources measured as a multifaceted outcome variable. Methods A trauma registry was used for a retrospective study of adult patients admitted to a midwestern level I trauma center. Patients were stratified into 3 groups: nonobese (normal weight, overweight), obese, and morbidly obese. Three canonical correlation analyses were used to determine the relationship between patient/injury characteristics and hospital resource usage. Results In a sample of 9771 patients, 71.2% were non-obese, 23.8% obese, and 5.0% morbidly obese. For patient/injury characteristics, Injury Severity Score and physiological complications were significant variables for all 3 groups. Scores on the Glasgow Coma Scale were significant for nonobese patients only. For resource usage, intensive care unit length of stay and procedures were significant variables for all 3 groups. Conclusions Associations between body mass index and outcomes have been noted when assessed as independent variables. However, when resource usage was assessed as a multifaceted outcome variable, injury factors (higher Injury Severity Score, lower scores on the Glasgow Coma Scale, more physiological complications) were associated with resource usage (increased length of stay in the intensive care unit and increased number of procedures). These findings provide clinicians a new perspective for evaluating the complex relationship between patient/injury characteristics and hospital resource usage.

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“…60 Inflammation and renal stone disease and gallstone disease Obesity was shown to be an independent risk factor for infection. 61,62 Inflammation is associated with risk of gallstones. Inflammation is associated with high risk of cholesterol gallstones.…”

Section: Cholesterol Gallstones and Renal Stone Disease And Diabetesmentioning

confidence: 99%

The association between renal stone disease and cholesterol gallstones: the easy to believe and not hard to retrieve theory of the metabolic syndrome

2014

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(2014) The association between renal stone disease and cholesterol gallstones: the easy to believe and not hard to retrieve theory of the metabolic syndrome, Renal Failure, 36:6,[957][958][959][960][961][962] AbstractRenal stone disease and gallstone disease are widely prevalent and costly disease across the globe. Both renal stone disease and gallstone disease are associated with a variety of diseases including obesity, metabolic syndrome, dyslipidemia, hypertension, insulin resistance diabetes and gout. Importantly, the presence of either renal stone disease or gallstone disease is associated with an increased risk of cardiovascular disease. In a recent study of the Atherosclerosis Risk in Communities (ARIC), individuals with a history of gallstones were 54% more likely to report a history of nephrolithiasis after adjusting for age, gender, body size and other factors. Furthermore, in three large cohorts including over 240,000 subjects: the Nurses' Health Studies (NHS) I and II and the Health Professionals Follow-up Study (HPFS), showed that gallstone disease is independently associated with nephrolithiasis. The mechanisms linking gallstone disease and renal stone disease are complex and not yet established. Insulin resistance, lithogenic diets, alterations of transporters in gallbladder and urinary system, and pH are possible potential mechanisms for future exploration. How the liver communicates with kidney in individuals with renal stone disease and gallstone disease is not well known and whether this communication is similar as in hepto-renal syndrome is subject for future research. Further research is needed to determine: (i) the underlying mechanisms of renal stone disease and gallstone disease; (ii) the potential treatment of renal stone disease and gallstone disease.

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Obesity as a Risk Factor for Nosocomial Infections in Trauma Patients

Cited by 91 publications

References 52 publications

Infectious complications in obese patients after trauma

Infectious complications in obese patients after trauma

Association of Injury Factors, Not Body Mass Index, With Hospital Resource Usage in Trauma Patients

The association between renal stone disease and cholesterol gallstones: the easy to believe and not hard to retrieve theory of the metabolic syndrome

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