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Erschienen in:
01.10.2014 | Original Article
The impact of body mass index and gender on the development of infectious complications in polytrauma patients
Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 5/2014
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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 ≥16 years. The sample was subdivided into three groups: BMI <25 kg/m2, BMI 25–30 kg/m2, and BMI >30 kg/m2, and a female and a male group. Infectious complications were observed for 31 days 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 <25 kg/m2 group, 29.0 % in the BMI 25–30 kg/m2 group, and 24.5 % in the BMI >30 kg/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.