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The impact of body mass index and gender on the development of infectious complications in polytrauma patients

Mica, L. ; Keller, C. ; Vomela, J. ; Trentz, O. ; Plecko, M. ; Keel, M.

In: European Journal of Trauma and Emergency Surgery, 2014, vol. 40, no. 5, p. 573-579

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    Titre
    • The impact of body mass index and gender on the development of infectious complications in polytrauma patients
    Auteur
    • Mica, L.. Division of Trauma Surgery, University Hospital Zürich, 8091, Zürich, Switzerland
    • Keller, C.. Department of Neurology, University Hospital of Cologne, Cologne, Germany
    • Vomela, J.. Department of Thoracic Surgery, University Hospital Brno, Brno, Czech Republic
    • Trentz, O.. Former Head of the Department of Trauma Surgery, University Hospital Zürich, Zürich, Switzerland
    • Plecko, M.. Division of Trauma Surgery, University Hospital Zürich, 8091, Zürich, Switzerland
    • Keel, M.. University Hospital of Orthopedic Surgery, Inselspital Bern, Bern, Switzerland
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • European Journal of Trauma and Emergency Surgery, 2014, vol. 40, no. 5, p. 573-579. Springer Berlin Heidelberg
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:325046
    Summary
    Purpose: The aim was to test the impact of body mass index (BMI) and gender on infectious complications after polytrauma. Methods: A total of 651 patients were included in this retrospective study, with an Injury Severity Score (ISS)≥16 and age≥16years. The sample was subdivided into three groups: BMI<25kg/m2, BMI 25-30kg/m2, and BMI>30kg/m2, and a female and a male group. Infectious complications were observed for 31days after admission. Data are given as mean±standard errors of the means. Analysis of variance, Kruskal-Wallis test, χ2 tests, and Pearson's correlation were used for the analyses and the significance level was set at P<0.05. Results: The overall infection rates were 31.0% in the BMI<25kg/m2 group, 29.0% in the BMI 25-30kg/m2 group, and 24.5% in the BMI>30kg/m2 group (P=0.519). The female patients developed significantly fewer infectious complications than the male patients (26.8 vs. 73.2%; P<0.001). The incidence of death was significantly decreased according to the BMI group (8.8 vs. 7.2 vs. 1.5%; P<0.0001) and the female population had a significantly lower mortality rate (4.1 vs. 13.4%; P<0.0001). Pearson's correlations between the Abbreviated Injury Scale (AIS) score and the corresponding infectious foci were not significant. Conclusion: Higher BMI seems to be protective against polytrauma-associated death but not polytrauma-associated infections, and female gender protects against both polytrauma-associated infections and death. Understanding gender-specific immunomodulation could improve the outcome of polytrauma patients.