Association of Body Mass Index With Severe Sepsis Outcomes in Critically-Ill Severely Injured Adult Trauma Patients: A National Analysis.

INTRODUCTION

The aim of this study is to evaluate clinical outcomes of critically-ill adult trauma patients with severe sepsis and severe injuries by body mass index (BMI) classification.

METHODS

This retrospective study utilized the American College of Surgeons Trauma Quality Improvement Program database from 2017 to 2021 to evaluate the relationship between BMI and severe sepsis outcomes. Patients included in this study included critically-ill adult (age ≥18 ys) trauma patients with severe injuries (injury severity score [ISS] ≥15) and a diagnosis of severe sepsis. The primary outcome was in-hospital mortality. Secondary outcomes included intensive care unit length-of-stay, ventilation-free-days, and complications, including acute respiratory distress syndrome, deep vein thrombosis, pulmonary embolism, ventilator-associated pneumonia, and acute kidney injury.

RESULTS

There were a total of 3268 patients included in this analysis. There was no significant association between obesity and odds of in-hospital mortality (odds ratio [OR]: 0.811, 95% confidence interval [CI]: 0.410-1.601, P = 0.545), intensive care unit length-of-stay (B = 5.114, 95% CI: -4.041-14.328, P = 0.268), ventilation-free-days (B = -0.280, 95% CI: -8.558-7.999, P = 0.946), deep vein thrombosis (OR: 1.625, 95% CI: 0.368-7.174, P = 0.522), pulmonary embolism (OR: 5.4 × 10ˆ14, 95% CI: 0.000-N/A, P = 0.992), acute respiratory distress syndrome (OR: 1.858, 95% CI: 0.668-5.179, P = 0.235), ventilator-associated pneumonia (OR: 0.809, 95% CI: 0.312-2.099, P = 0.664), or acute kidney injury (OR: 0.984, 95% CI: 0.449-2.154, P = 0.967) when compared to being normal weight. There was also no significant association between the remaining BMI classifications and all study outcomes.

CONCLUSIONS

Obesity had no association with outcomes of severely injured critically ill adult trauma patients with severe sepsis as demonstrated through comparable clinical outcomes between study populations regardless of BMI classification.