Skip to main content

Advertisement

SpringerLink
Log in

The impact of body mass index on severity, patterns and outcomes after traumatic brain injuries caused by low level falls

  • Original Article
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Low level falls are a common cause of traumatic brain injuries (TBI) and are associated with significant mortality and disability. The aim of this study was to analyse whether BMI, height and weight of patients were related to severity, patterns and outcomes of TBI caused by low level falls.

Methods

Data on patients with TBI where cause of injury was a low level fall (fall < 3 m) with known body mass index (BMI) (N = 683) were analysed. Patients were categorized into underweight, normal, pre-obese and obese based on BMI and demographic characteristics, injury severity, patterns and outcomes were compared. In addition, physiological status, comorbidities and length of hospitalization were analysed in a subset of patients where this information was available.

Results

The median BMI was 25.6. About 1/10 of patients were obese. The mean age and proportion of male sex of patients was increasing with increasing BMI. The patients in all BMI groups were of similar injury severity and neurological status. There was also no difference in mortality and functional outcome based on patient’s BMI. Obese and pre-obese patients required longer stay at ICU and in hospital.

Conclusion

We found no associations between BMI and severity or outcome of TBI caused by low level falls. More detailed data and further studies are needed to fully elucidate these complex relationships.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Toevs CC. Trauma in obese patients. Crit Care Clin. 2010;26(4):689–93. doi:10.1016/j.ccc.2010.06.010.

    Article  PubMed  Google Scholar 

  2. Newell MA, Bard, Goettler CE, Toschlog EA, Schenarts PJ, Sagraves SG, et al. Body mass index and outcomes in critically injured blunt trauma patients: weighing the impact. J Am Coll Surg. 2007;204(5):1056–61. doi:10.1016/j.jamcollsurg.2006.12.042 (Discussion 62–4).

    Article  PubMed  Google Scholar 

  3. Osborne Z, Rowitz B, Moore H, Oliphant U, Butler J, Olson M, et al. Obesity in trauma: outcomes and disposition trends. Am J Surg. 2014;207(3):387–92. doi:10.1016/j.amjsurg.2013.10.013.

    Article  PubMed  Google Scholar 

  4. Maas AI, Stocchetti N, Bullock R. Moderate and severe traumatic brain injury in adults. Lancet Neurol. 2008;7(8):728–41. doi:10.1016/S1474-4422(08)70164-9.

    Article  PubMed  Google Scholar 

  5. Brown CV, Neville AL, Rhee P, Salim A, Velmahos GC, Demetriades D. The impact of obesity on the outcomes of 1,153 critically injured blunt trauma patients. J Trauma. 2005;59(5):1048–51 (Discussion 51).

    Article  PubMed  Google Scholar 

  6. Tagliaferri F, Compagnone C, Yoganandan N, Gennarelli TA. Traumatic brain injury after frontal crashes: relationship with body mass index. J Trauma. 2009;66(3):727–9. doi:10.1097/TA.0b013e31815edefd.

    Article  PubMed  Google Scholar 

  7. Majdan M, Mauritz W, Brazinova A, Rusnak M, Leitgeb J, Janciak I, et al. Severity and outcome of traumatic brain injuries (TBI) with different causes of injury. Brain Inj [BI]. 2011;25(9):797–805. doi:10.3109/02699052.2011.581642.

    Article  Google Scholar 

  8. Mauritz W, Brazinova A, Majdan M, Leitgeb J. Epidemiology of traumatic brain injury in Austria. Wien Klin Wochenschr. 2014;126(1–2):42–52. doi:10.1007/s00508-013-0456-6.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Roozenbeek B, Maas AI, Menon DK. Changing patterns in the epidemiology of traumatic brain injury. Nat Rev Neurol. 2013;9(4):231–6. doi:10.1038/nrneurol.2013.22.

    Article  PubMed  Google Scholar 

  10. WHO. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. Geneva: World Health Organization 2000.

  11. R-Core-Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2013. URL http://www.R-project.org/. Accessed 21 Oct 2014.

  12. Pohlert T. The Pairwise Multiple Comparison of Mean Ranks Package (PMCMR). 2014. R package.

  13. Steyerberg EW, Mushkudiani N, Perel P, Butcher I, Lu J, McHugh GS, et al. Predicting outcome after traumatic brain injury: development and international validation of prognostic scores based on admission characteristics. PLoS Med. 2008;5(8):e165. doi:10.1371/journal.pmed.0050165 (Discussion e).

    Article  PubMed Central  PubMed  Google Scholar 

  14. Ryb GE, Dischinger PC. Injury severity and outcome of overweight and obese patients after vehicular trauma: a crash injury research and engineering network (CIREN) study. J Trauma. 2008;64(2):406–11. doi:10.1097/TA.0b013e31802beff9.

    Article  PubMed  Google Scholar 

  15. Bochicchio GV, Joshi M, Bochicchio K, Nehman S, Tracy JK, Scalea TM. Impact of obesity in the critically ill trauma patient: a prospective study. J Am Coll Surg. 2006;203(4):533–8. doi:10.1016/j.jamcollsurg.2006.07.001.

    Article  PubMed  Google Scholar 

  16. Byrnes MC, McDaniel MD, Moore MB, Helmer SD, Smith RS. The effect of obesity on outcomes among injured patients. J Trauma. 2005;58(2):232–7.

    Article  PubMed  Google Scholar 

  17. Hoffmann M, Lefering R, Gruber-Rathmann M, Rueger JM, Lehmann W, Trauma Registry of the German Society for Trauma S. The impact of BMI on polytrauma outcome. Injury. 2012;43(2):184–8. doi:10.1016/j.injury.2011.05.029.

    Article  PubMed  Google Scholar 

  18. Jehle D, Gemme S, Jehle C. Influence of obesity on mortality of drivers in severe motor vehicle crashes. Am J Emerg Med. 2012;30(1):191–5. doi:10.1016/j.ajem.2010.10.017.

    Article  PubMed  Google Scholar 

  19. Mock CN, Grossman DC, Kaufman RP, Mack CD, Rivara FP. The relationship between body weight and risk of death and serious injury in motor vehicle crashes. Accid; Anal Prev. 2002;34(2):221–8.

    Article  PubMed  Google Scholar 

  20. Neville AL, Brown CV, Weng J, Demetriades D, Velmahos GC. Obesity is an independent risk factor of mortality in severely injured blunt trauma patients. Arch Surg. 2004;139(9):983–7. doi:10.1001/archsurg.139.9.983.

    Article  PubMed  Google Scholar 

  21. Majdan M, Mauritz W, Wilbacher I, Janciak I, Brazinova A, Rusnak M, et al. Traumatic brain injuries caused by traffic accidents in five European countries: outcome and public health consequences. Eur J Pub Health. 2013;23(4):682–7. doi:10.1093/eurpub/cks074.

    Article  Google Scholar 

Download references

Acknowledgments

We are very grateful to the investigators of the studies within which the data for this analyses were collected who enrolled patients and collected data: Hospital Amstetten (A. Frisch MD, A. Liedler MD, Harald Schmied MD); hospital Feldkirch (R. Folie MD, R. Germann MD PhD, J. Graber RN ICU), Graz University hospital (K. Michaeli MD, R.F. Oswald MD, A. Waltensdorfer MD), trauma hospital Graz (T. Haidacher MD, J. Menner MD), hospital Horn (A. Hüblauer MD, E. Nödl MD), Innsbruck University hospital (Ch. Freund MD, KH. Stadlbauer MD), general hospital Klagenfurt (M. Oher MD, E. Trampitsch MD, A. Zechner MD), generalhospital Linz (F. Gruber MD, W. Mitterndorfer MD, S. Rathmaier MS), traumahospital Linz (N. Bauer MD),generalhospital Salzburg (P. Hohenauer MD), traumahospital Salzburg (J. Lanner MD, W. Voelckel Prof. MD), generalhospital Sankt Poelten (C. Mirth MD), hospital Schwarzach (H. Artmann MD, B. Cudrigh MD), general hospital Wiener Neustadt (D. Csomor MD, G. Herzer MD, A. Hofinger MD, H. Trimmel MD), traumahospital Wien Meidling (V. Lorenz MD, H. Steltzer Prof. MD), trauma hospital Wien „Lorenz Boehler“(W. Mauritz Prof. MD) and others. The data used for this study was collected for multiple projects: a project funded by the Ministry of Health (Contract Oct. 15, 2008) and the Austrian Worker’s Compensation Board (AUVA; FK 11/2008 and FK 11/2010); the project: An International Health Care Initiative: Improving Patient Outcome from Head Injury in Central and Eastern Europe (1999–2001) was funded by the Open Society Institute; and the project: Reducing mortality and long-term disability of TBI victims through research into treatment procedures used in Bosnia-Herzegovina, Macedonia and Croatia (“RESEARCH TREAT TBI”) was financed by the European Community, Program INCO-DEV: International Cooperation with Developing Countries (1998–2002) Project no. ICA2-CT-2002-10005. INRO is supported by an annual grant from Mrs. Ala Auersperg-Isham and Mr. Ralph Isham, and by small donations from various sources. The work of Marek Majdan on this paper was partly funded by an institutional grant of the Trnava University (grant #12/TU/2014).

Conflict of interest

Marek Majdan, PhD., Alexandra Brazinova, PhD., Ingrid Wilbacher, PhD., Prof. Martin Rusnak, MD, PhD. and Prof. Walter Mauritz MD, PhD. declare that they have no conflicts of interest.

Ethical standard statement

All studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.

Author information

Authors and Affiliations

  1. Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Hornopotocna 23, 91843, Trnava, Slovakia

    M. Majdan, A. Brazinova & M. Rusnak

  2. International Neurotrauma Research Organisation (INRO), Moelkergasse 4/3, 1080, Vienna, Austria

    M. Majdan, A. Brazinova, I. Wilbacher, M. Rusnak & W. Mauritz

Authors
  1. M. Majdan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Brazinova
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. I. Wilbacher
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Rusnak
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. W. Mauritz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Majdan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Majdan, M., Brazinova, A., Wilbacher, I. et al. The impact of body mass index on severity, patterns and outcomes after traumatic brain injuries caused by low level falls. Eur J Trauma Emerg Surg 41, 651–656 (2015). https://doi.org/10.1007/s00068-014-0490-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00068-014-0490-8

Keywords

Search

Navigation