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Traumatologisches Outcome in Abhängigkeit vom Ernährungszustand

Nutritional status influences trauma outcome

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Zusammenfassung

Die Polytraumasterblichkeit ist seit Jahren rückläufig. Da die Prävalenz der Adipositas in den letzten Jahren deutlich gestiegen ist, finden sich übergewichtige und adipöse Patienten auch zunehmend im Kollektiv polytraumatisierter Patienten. Der „Body-Mass-Index“ ermöglicht Rückschlüsse auf den Ernährungszustand. In der Literatur werden unterschiedliche Einflüsse des Ernährungszustands auf das traumatologische Outcome beschrieben. Neben Adipositas ist auch Untergewicht mit erhöhter Mortalität assoziiert. Untergewichtige Patienten zeigen eine erhöhte frühe Polytraumamortalität, während adipöse Patienten eine erhöhte Inzidenz von Multiorganversagen und Sepsis sowie eine späte Polytraumasterblichkeit aufweisen.

Abstract

Polytrauma mortality rates are continuously decreasing over the last years. Due to rising prevalence of obesity, patients with overweight and obesity are rising in numbers within the polytrauma collective. The body mass index (BMI) provides information about the nutritional status. Varying results have been reported concerning the effect of BMI on polytrauma outcome. Both obesity and underweight are independent risk factors for increased polytrauma mortality. While underweight is associated with early polytrauma mortality, obesity shows higher rates of multi organ failure and sepsis and is associated with late polytrauma mortality.

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Literatur

  1. Bundesministerium für Gesundheit (2004) Gesundheitsberichterstattung Berlin. Basisbericht 2003/2004. BMG, Bonn

  2. Statistisches Bundesamt Deutschland (2006) Statistisches Bundesamt Deutschland – Pressemitteilung Nr. 227. Statistisches Bundesamt Deutschland, Wiesbaden

  3. Maheshwari R, Mack CD, Kaufman RP et al (2009) Severity of injury and outcomes among obese trauma patients with fractures of the femur and tibia: a crash injury research and engineering network study. J Orthop Trauma 23(9):634–639

    Article  PubMed  Google Scholar 

  4. Neville AL, Brown CV, Weng J et al (2004) Obesity is an independent risk factor of mortality in severely injured blunt trauma patients. Arch Surg 139:983–987

    Article  PubMed  Google Scholar 

  5. Pi-Sunyer FX, Dietz WH, Becker DM et al (1998) Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. National Heart, Lung, and Blood Institute, Bethesda MD

  6. Troiano RP, Frongillo EA Jr, Sobal J et al (1996) The relationship between bodyweight and mortality: a quantative analysis of combined information from existing studies. Int J Obes Relat Metab Disord 20:63–75

    PubMed  CAS  Google Scholar 

  7. Hoffmann M, Lefering R, Gruber-Rathmann M et al (2011) The impact of BMI on polytrauma outcome. Injury (Epub ahead of print)

  8. Byrnes MC, McDaniel MD, Moore MB et al (1991) Obesity and increased mortality in blunt trauma. J Trauma 31:1253–1257

    Article  Google Scholar 

  9. Bochicchio GV, Joshi M, Bochicchio K et al (2006) Impact of obesity in the critically ill trauma patient: a prospective study. J Am Coll Surg 203(4):533–538

    Article  PubMed  Google Scholar 

  10. Brown CV, Neville AL, Rhee P et al (2005) The impact of obesity on the outcomes of 1,153 critically injured blunt trauma patients. J Trauma 59(5):1048–1051Manson JE, Stampfer MJ et al (1987) Body weight and longevity. A reassessment. JAMA 257(3):353–358

    Google Scholar 

  11. Manson JE, Colditz GA, Stampfer MJ et al. (1987) Body weight and longevity. A reassessment. JAMA 257(3):353–358

    Article  PubMed  CAS  Google Scholar 

  12. Tremblay A, Bandi V (2003) Impact of body mass index on outcomes following critical care. Chest 123(4):1202–1207

    Article  PubMed  Google Scholar 

  13. Smith-Choban P, Weireter LJ, Maynes C (1991) Obesity and increased mortality in blunt trauma. J Trauma 31:1253–1257

    Article  Google Scholar 

  14. Cowley RA (1976) The resuscitation and stabilization of major multiple trauma patients in a trauma center environment. Clin Med 83:16–22

    Google Scholar 

  15. Trunkey DD (1983) Trauma. Sci Am 249:28–35

    Article  PubMed  CAS  Google Scholar 

  16. Gunst M, Ghaemmaghami V, Gruszeck A et al (2010) Changing epidemiology of trauma deaths leads to a bimodal distribution. Proc (Bayl Univ Med Cent) 23(4):349–354

    Google Scholar 

  17. Arabi S, Wahl WL, Hemmila MR et al (2003) The cushion effect. J Trauma 54:1090–1093

    Article  Google Scholar 

  18. Dischinger PC, Kerns TJ, Kufera JA (1995) Lower extremity fractures in motor vehicle collisions: the role of driver gender and height. Accid Anal Prev 27(4):601–606

    Article  PubMed  CAS  Google Scholar 

  19. Boulanger BR, Milzman D, Mitchell K et al (1992) Body habitus as a predictor of injury pattern after blunt trauma. J Trauma 33:228–232

    Article  PubMed  CAS  Google Scholar 

  20. Ciesla DJ, Moore EE, Johnson JL et al (2006) Obesity increases risk of organ failure after severe trauma. J Am Coll Surg 203(4):539–545

    Article  PubMed  Google Scholar 

  21. Sems SA, Johnson M, Cole PA et al (2010) Elevated body mass index increases early complications of surgical treatment of pelvic ring injuries. J Orthop Trauma 24(5):309–314

    Article  PubMed  Google Scholar 

  22. Serrano PE, Khuder SA, Fath JJ (2010) Obesity as a risk factor for nosocomial infections in trauma patients. J Am Coll Surg 211(1):61–67

    Article  PubMed  Google Scholar 

  23. Ghanem AM, Sen S, Philp B et al (2011) Body Mass Index (BMI) and mortality in patients with severe burns: is there a „tilt point“ at which obesity influences outcome? Burns 37(2):208–214

    Article  PubMed  Google Scholar 

  24. Rana AR, Michalsky MP, Teich S et al (2009) Childhood obesity: a risk factor for injuries observed at a level-1 trauma center. J Pediatr Surg 44(8):1601–1605

    Article  PubMed  Google Scholar 

  25. Brown CV, Neville AL, Salim A et al (2006) The impact of obesity on severely injured children and adolescents. J Pediatr Surg 41(1):88–91

    Article  PubMed  Google Scholar 

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  1. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland

    M. Hoffmann MBA & J.M. Rueger

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  1. M. Hoffmann MBA
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  2. J.M. Rueger
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Correspondence to M. Hoffmann MBA.

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Hoffmann, M., Rueger, J. Traumatologisches Outcome in Abhängigkeit vom Ernährungszustand. Unfallchirurg 114, 968–972 (2011). https://doi.org/10.1007/s00113-011-2034-6

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  • DOI: https://doi.org/10.1007/s00113-011-2034-6

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