The impact of body mass index on the development of systemic inflammatory response syndrome and sepsis in patients with polytrauma

Injury. 2014 Jan;45(1):253-8. doi: 10.1016/j.injury.2012.11.015. Epub 2012 Dec 20.

Abstract

Purpose: Obesity is a growing problem in industrial nations. Our aim was to examine how overweight patients coped with systemic inflammatory response syndrome (SIRS) after polytrauma.

Methods: A total of 651 patients were included in this retrospective study, with an ISS ≥ 16 and age ≥ 16 years. The sample was subdivided into three groups: body mass index (BMI; all in kg/m(2))<25, BMI 25-30 and BMI>30, or low, intermediate and high BMI. The SIRS score was measured over 31 days after admission together with measurements of C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT). Data are given as the mean ± SEM if not otherwise indicated. Kruskal-Wallis and χ(2) tests were used for statistical analysis and the significance level was set at p<.05.

Results: The maximum SIRS score was reached in the low BMI-group at 3.4 ± 0.4, vs. 2.3 ± 0.1 and 2.5 ± 0.2 in the intermediate BMI-group and high BMI-group, respectively (p<.0001). However, the maximum SIRS score was reached earlier in the BMI 25-30 group at 1.8 ± 0.2 days, vs. 3.4 ± 0.4 and 2.5 ± 0.2 days in the BMI<25 and BMI>30 groups, respectively (p<.0001). The incidence of sepsis was significantly higher in the low BMI group at 46.1%, vs. 0.2% and 0% in the BMI 25-30 and BMI>30 groups, respectively (p<.0001). No significant differences in the CRP, IL-6 or PCT levels were found between groups.

Conclusions: A higher BMI seemed to be protective for these patients with polytrauma-associated inflammatory problems.

Keywords: Body mass index; C-reactive protein; Interleukin-6; Polytrauma; Procalcitonin; SIRS; Sepsis.

MeSH terms

  • Adult
  • Aged
  • Body Mass Index*
  • C-Reactive Protein / metabolism
  • Calcitonin / metabolism
  • Calcitonin Gene-Related Peptide
  • Female
  • Humans
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Multiple Trauma*
  • Obesity / metabolism
  • Protein Precursors / metabolism
  • Retrospective Studies
  • Sepsis / blood
  • Sepsis / diagnosis
  • Sepsis / epidemiology*
  • Systemic Inflammatory Response Syndrome / blood
  • Systemic Inflammatory Response Syndrome / diagnosis
  • Systemic Inflammatory Response Syndrome / epidemiology*

Substances

  • CALCA protein, human
  • Interleukin-6
  • Protein Precursors
  • Calcitonin
  • C-Reactive Protein
  • Calcitonin Gene-Related Peptide