The weighty issue: the impact of Body Mass Index (BMI) in Asian trauma patients

Published in Hong Kong Journal of Emergency Medicine on September 2012

Y.X. Teo 1, L.T. Teo 2, K.T.S. Go 2, Y.T. Yeo 2, V. Appasamy 2, M.T. Chiu 2
1 Emergency Department, Tan Tock Seng Hospital, Singapore
2 Trauma Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore

Abstract

Background

The controversy surrounding the impact of Body Mass Index (BMI) on the outcome of trauma patients has been widely studied in the West. However, no such studies have looked at an Asian trauma population. The aim of our study was to investigate the impact of BMI on mortality, morbidity, severity and pattern of injury in trauma patients of multicultural Singapore.

Methods

In this prospective study, we recruited all trauma patients admitted to Tan Tock Seng Hospital over a 13 month period. Both the international World Health Organization (WHO) and Asian modified classifications of BMI were used for the purpose of our study. Patient demographics, co-morbidities, mechanism of injury, injury severity score (ISS), body regions injured, morbidity and mortality were collected using inpatient medical records.

Results

964 patients with a mean age of 50.5 years were recruited. Majority of injuries sustained were due to falls. There was no association between Asian BMI and ISS. Head, neck and cervical injuries occurred less commonly in the overweight and obese group, but BMI does not confer protection from truncal injury. BMI was not a significant risk factor for morbidity or mortality.

Conclusion

Being overweight does not appear to increase severity of injury in Asian trauma patients. BMI as an independent risk factor does not contribute to trauma mortality or morbidity. We conclude that BMI is not a significant contributing factor to adverse trauma outcomes in Asians.

背景

身體質量指數（BMI）對外傷患者後果的影響，在西方已被廣泛研究。然而，沒有著眼於亞洲 創傷人口的研究。我們的研究目的，是探討在多元文化的新加坡，BMI對創傷患者的死亡率，發病率，嚴重程度和損傷模式的影響。方法：在這項前瞻性的研究，我們招募了13個月內陳篤生醫院收治的所有外傷患者。我們的研究兼用了世界衛生組織（WHO）的國際版BMI 分類和亞洲修正版本。我們使用

住院病歷，收集病人的人口統計資料，共病，創傷機制，創傷程度評分（ISS），受傷的身體部位，發病率和死亡率。結果：我們招募了964例平均年齡50.5歲的患者。大部分的受傷是由於跌倒。亞洲BMI和ISS之間沒有任何關聯。頭部，頸部和頸椎創傷較少發生在超重和肥胖患者，但BMI對軀幹創傷並無保護。BMI並不是發病率或死亡率的重要危險因素。結論：超重看來不會令外傷患者的受傷嚴重程度增加。BMI作為一個獨立的危險因素，不影響創傷的死亡率或發病率。我們的結論是：在亞洲人的不良創傷後果， BMI 不是一個重要因素。