Obesity in polytrauma patients appears protective vs death

Polytrauma patients with obesity appear to have a lower risk of death and shorter length of hospital stays, suggests a study.

Researchers included a total of 1,234 polytrauma patients categorized by World Health Organization Asia-Pacific BMI classifications. They performed inverse probability of treatment weighting to minimize baseline bias and used Cox proportional hazards models to assess the impact of BMI on mortality.

The 30-day mortality rates were 7.5 percent for patients with underweight (<18.5 kg/m²), 9.0 percent for normal weight (18.5–22.9 kg/m²), 6.7 percent for overweight (23.0–24.9 kg/m²), 2.4 percent for obesity class I (25.0–29.9 kg/m²), and 2.6 percent for obesity class II (>30.0 kg/m²). For 365-day mortality, the respective rates were 12.5 percent, 15.0 percent, 12.6 percent, 7.5 percent, and 7.7 percent.

Only patients with obesity class I showed a significantly lower risk of 30-day (hazard ratio [HR], 0.19, 95 percent confidence interval [CI], 0.06–0.66; p=0.00864) and 365-day mortality (HR, 0.57, 95 percent CI, 0.33–0.99; p=0.0448).

Additionally, patients with obesity class II had significantly shorter hospitalization duration than those with normal weight (mean 6.08 vs 12.50 days; p<0.001).

“The obesity paradox survival advantage occurs only in polytrauma patients with obesity class I, whereas those with obesity class II tend to have shorter hospital stays,” the researchers said. 

“The obesity paradox suggests that higher BMI values might be protective in certain conditions,” they noted.