부산대학교 도서관

BackgroundPatient-related risk factors for the development of postoperative pulmonary complications (PPCs) include age ≥ 60-years, congestive heart failure, hypoalbuminemia and smoking. The effect of obesity is unclear and has not been shown to independently increase the likelihood of PPCs in trauma patients undergoing trauma laparotomy. We hypothesized the likelihood of mortality and PPCs would increase as body mass index (BMI) increases in trauma patients undergoing trauma laparotomy.MethodsThe Trauma Quality Improvement Program (2010-2016) was queried to identify trauma patients ≥ 18-years-old undergoing trauma laparotomy within 6-h of presentation. A multivariable logistic regression analysis was used to determine the likelihood of PPCs and mortality when stratified by BMI.ResultsFrom 8,330 patients, 2,810 (33.7%) were overweight (25-29.9 kg/m2), 1444 (17.3%) obese (30-34.9 kg/m2), 580 (7.0%) severely obese (35-39.9 kg/m2), and 401 (4.8%) morbidly obese (≥ 40 kg/m2). After adjusting for covariates including age, injury severity score, chronic obstructive pulmonary disease, smoking, and rib/lung injury, the likelihood of PPCs increased with increasing BMI: overweight (OR = 1.37, CI 1.07-1.74, p = 0.012), obese (OR = 1.44, CI 1.08-1.92, p = 0.014), severely obese (OR = 2.20, CI 1.55-3.14, p