Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
권호 표지
DOI QR코드

DOI QR Code

Impact of obesity on the severity of trauma in patients injured in pedestrian traffic accidents

  • Pillsung, Oh (Department of Emergency Medicine, Gil Medical Center) ;
  • Jin-Seong, Cho (Department of Emergency Medicine, Gil Medical Center) ;
  • Jae Ho, Jang (Department of Emergency Medicine, Gil Medical Center) ;
  • Jae Yeon, Choi (Department of Emergency Medicine, Gil Medical Center) ;
  • Woo Sung, Choi (Department of Emergency Medicine, Gil Medical Center) ;
  • Byungchul, Yu (Department of Traumatology, Gil Medical Center, Gachon University College of Medicine)
  • Received : 2021.07.02
  • Accepted : 2021.10.06
  • Published : 2022.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Studies on the relationship between obesity and injuries, especially those sustained in pedestrian traffic accidents, are lacking. We aimed to assess the effects of obesity on the severity of injury at the time of admission to the emergency room in patients who experienced pedestrian traffic accidents. Methods: This study included trauma patients registered in the Korean Trauma Database from July 1, 2018 to December 31, 2020, whose mechanism of injury was pedestrian traffic accidents and who were treated at a single institution. Those aged below 15 years were excluded. Patients were assigned to nonobese and obese groups based on a body mass index of 25 kg/m2. An Injury Severity Score of 25 or greater was considered to indicate a critical injury. Results: In total, 679 cases of pedestrian traffic accidents were registered during the study period, and 543 patients were included in the final analysis. Of them, 360 patients (66.3%) and 183 patients (33.7%) were categorized as nonobese and obese, respectively. The median age was significantly higher in the nonobese group than in the obese group (60 vs. 58 years). Multivariate analysis demonstrated that the odds ratio for critical injury in obese patients was 1.59 (95% confidence interval, 1.01-2.48) compared with nonobese patients. Conclusions: Obesity affected the likelihood of sustaining severe injuries in pedestrian traffic accidents. Future studies should analyze the effects of body mass index on the pattern and severity of injuries in patients with more diverse injury mechanisms using large-scale data.

Keywords

References

  1. Manson JE, Colditz GA, Stampfer MJ, et al. A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med 1990;322:882-9. https://doi.org/10.1056/NEJM199003293221303
  2. Marini S, Merino J, Montgomery BE, et al. Mendelian randomization study of obesity and cerebrovascular disease. Ann Neurol 2020;87:516-24. https://doi.org/10.1002/ana.25686
  3. Morris RD, Rimm DL, Hartz AJ, Kalkhoff RK, Rimm AA. Obesity and heredity in the etiology of non-insulin-dependent diabetes mellitus in 32,662 adult white women. Am J Epidemiol 1989;130:112-21. https://doi.org/10.1093/oxfordjournals.aje.a115302
  4. Kotsis V, Stabouli S, Bouldin M, Low A, Toumanidis S, Zakopoulos N. Impact of obesity on 24-hour ambulatory blood pressure and hypertension. Hypertension 2005;45:602-7. https://doi.org/10.1161/01.hyp.0000158261.86674.8e
  5. Howard BV, Ruotolo G, Robbins DC. Obesity and dyslipidemia. Endocrinol Metab Clin North Am 2003;32:855-67. https://doi.org/10.1016/S0889-8529(03)00073-2
  6. Vucenik I, Stains JP. Obesity and cancer risk: evidence, mechanisms, and recommendations. Ann N Y Acad Sci 2012;1271:37-43. https://doi.org/10.1111/j.1749-6632.2012.06750.x
  7. World Health Organization (WHO). Obesity: preventing and managing the global epidemic: report of a WHO consultation [Internet]. Geneva: WHO; 2000 [cited 2021 Apr 23]. Available from: https://apps.who.int/iris/handle/10665/42330/.
  8. Korea Centers for Disease Control and Prevention. Korea national health statistics [Internet]. Cheongju: Korea Centers for Disease Control and Prevention; 2018 [cited 2021 Apr 23]. Available from: https://knhanes.kdca.go.kr/knhanes/sub04/ sub04_04_01.do.
  9. Dubois S, Mushquash AR, Weaver B, Beedard M. Age modifies the association between driver's body mass index and death following motor vehicle crashes. Traffic Inj Prev 2018;19:728-33. https://doi.org/10.1080/15389588.2018.1508833
  10. Ma X, Laud PW, Pintar F, et al. Obesity and non-fatal motor vehicle crash injuries: sex difference effects. Int J Obes (Lond) 2011;35:1216-24. https://doi.org/10.1038/ijo.2010.270
  11. Yu BC, Chung M, Lee GJ, et al. Analysis of KTDB registered trauma patients from a single trauma center in Korea. J Trauma Inj 2015;28:123-8. https://doi.org/10.20408/jti.2015.28.3.123
  12. Korean Society for the Study of Obesity. Guideline for the management of obesity in Korea [Internet]. Seoul: Korean Society for the Study of Obesity; 2014 [cited 2021 Apr 23]. http://general.kosso.or.kr/html/?pmode=BBBS0001300003&page=1&smode=view&seq=1214&searchValue=&searchTitle=strTitle&set%20RowCount=undefined.
  13. World Health Organization (WHO). The Asia-Pacific perspective: redefinding obesity and its treatment [Internet]. Geneva: WHO; 2000 [cited 2021 Apr 23]. Available from: https://apps.who.int/iris/handle/10665/206936.
  14. Rating the severity of tissue damage. I. The abbreviated scale. JAMA 1971;215:277-80. https://doi.org/10.1001/jama.1971.03180150059012
  15. Rupp JD, Flannagan CA, Leslie AJ, Hoff CN, Reed MP, Cunningham RM. Effects of BMI on the risk and frequency of AIS 3+ injuries in motor-vehicle crashes. Obesity (Silver Spring) 2013;21:E88-97. https://doi.org/10.1002/oby.20079
  16. Carter PM, Flannagan CA, Reed MP, Cunningham RM, Rupp JD. Comparing the effects of age, BMI and gender on severe injury (AIS 3+) in motor-vehicle crashes. Accid Anal Prev 2014;72:146-60. https://doi.org/10.1016/j.aap.2014.05.024
  17. Baker SP, O'Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 1974;14:187-96. https://doi.org/10.1097/00005373-197403000-00001
  18. Bolorunduro OB, Villegas C, Oyetunji TA, et al. Validating the injury severity score (ISS) in different populations: ISS predicts mortality better among Hispanics and females. J Surg Res 2011;166:40-4. https://doi.org/10.1016/j.jss.2010.04.012
  19. Stevenson M, Segui-Gomez M, Lescohier I, Di Scala C, McDonald-Smith G. An overview of the injury severity score and the new injury severity score. Inj Prev 2001;7:10-3. https://doi.org/10.1136/ip.7.1.10
  20. Conroy C, Tominaga GT, Erwin S, et al. The influence of vehicle damage on injury severity of drivers in head-on motor vehicle crashes. Accid Anal Prev 2008;40:1589-94. https://doi.org/10.1016/j.aap.2008.04.006
  21. Durgun HM, Dursun R, Zengin Y, et al. The effect of body mass index on trauma severity and prognosis in trauma patients. Ulus Travma Acil Cerrahi Derg 2016;22:457-65.
  22. Duane TM, Dechert T, Aboutanos MB, Malhotra AK, Ivatury RR. Obesity and outcomes after blunt trauma. J Trauma 2006;61:1218-21. https://doi.org/10.1097/01.ta.0000241022.43088.e1
  23. Liu HT, Rau CS, Wu SC, et al. Obese motorcycle riders have a different injury pattern and longer hospital length of stay than the normal-weight patients. Scand J Trauma Resusc Emerg Med 2016;24:50.
  24. Chuang JF, Rau CS, Liu HT, et al. Obese patients who fall have less injury severity but a longer hospital stay than normal-weight patients. World J Emerg Surg 2016;11:3.
  25. Kim JE, Kim IH, Shum PC, et al. A computational study of injury severity and pattern sustained by overweight drivers in frontal motor vehicle crashes. Comput Methods Biomech Biomed Engin 2014;17:965-77. https://doi.org/10.1080/10255842.2012.728589
  26. Tagliaferri F, Compagnone C, Yoganandan N, Gennarelli TA. Traumatic brain injury after frontal crashes: relationship with body mass index. J Trauma 2009;66:727-9. https://doi.org/10.1097/TA.0b013e31815edefd
  27. Desapriya E, Giulia S, Subzwari S, et al. Does obesity increase the risk of injury or mortality in motor vehicle crashes? A systematic review and meta-analysis. Asia Pac J Public Health 2014;26:447-60. https://doi.org/10.1177/1010539511430720
  28. Lee HH, Cho JS, Lim YS, et al. Relationship between age and injury severity in traffic accidents involving elderly pedestrians. Clin Exp Emerg Med 2019;6:235-41. https://doi.org/10.15441/ceem.18.052
  29. Zhu M, Zhao S, Coben JH, Smith GS. Why more male pedestrians die in vehicle-pedestrian collisions than female pedestrians: a decompositional analysis. Inj Prev 2013;19:227-31. https://doi.org/10.1136/injuryprev-2012-040594