Jonathan P Japa, Alina Shats, Philip Zitser, Nisha Lakhi
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Incidence of bone fractures and injury severity were compared between both groups using injury severity score (ISS) and abbreviated injury scale (AIS). For variables significant on univariate analysis, binary logistic regression models were used to control age, gender, restraint use, and airbag deployment.</p><p><strong>Results: </strong>The mean number of fractures (0.62 vs 0.46, p=0.096) and ISS (4.55 vs 4.51, p=0.703) were similar between the obese and non-obese groups. However, obese patients were more likely to experience upper extremity fractures (7.3% vs 3.4%, p=0.045) and lower extremity fractures (7.3% vs 2.7%, p =0.01), particularly fractures of the tibia/fibula (5.6% vs 1.6%, p=0.008). No significant differences were found in the incidence of head, thoracolumbar, or pelvic fractures between the two groups. After controlling for age, gender, restraint use, and airbag deployment, obesity remained an independent predictor of lower extremity fracture (aOR) 2.62 (95% CI: 1.01-6.56), p = 0.04).</p><p><strong>Conclusion: </strong>Obesity is an independent predictor of lower extremity fractures following a MVA. Clinicians should acknowledge potential differences in fracture occurrence and patterns between obese and non-obese patients during triage.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"17 ","pages":"185-193"},"PeriodicalIF":1.5000,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094485/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of Obesity on Orthopedic Injury and Fracture Patterns in Motor Vehicle Accidents.\",\"authors\":\"Jonathan P Japa, Alina Shats, Philip Zitser, Nisha Lakhi\",\"doi\":\"10.2147/OAEM.S490123\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Obese trauma patients face a higher risk of mortality, prolonged ICU stays, and more complications than non-obese patients. However, some studies suggest that obesity might provide protective benefits in high-impact trauma situations through the \\\"cushion effect\\\". This study will examine whether obesity influences fracture occurrence, injury severity, and clinical outcomes in motor vehicle accidents (MVA).</p><p><strong>Methods: </strong>A retrospective study of 555 adult patients who presented to a Level 1 Trauma Center following a MVA from 2010-2022. Patients with a Body Mass Index (BMI) greater than or equal to 30 kg/m<sup>2</sup> were categorized as obese (178 patients, 32.6%), and those with a BMI less than 30 kg/m<sup>2</sup> were classified as non-obese (377 patients, 67.4%). Incidence of bone fractures and injury severity were compared between both groups using injury severity score (ISS) and abbreviated injury scale (AIS). For variables significant on univariate analysis, binary logistic regression models were used to control age, gender, restraint use, and airbag deployment.</p><p><strong>Results: </strong>The mean number of fractures (0.62 vs 0.46, p=0.096) and ISS (4.55 vs 4.51, p=0.703) were similar between the obese and non-obese groups. However, obese patients were more likely to experience upper extremity fractures (7.3% vs 3.4%, p=0.045) and lower extremity fractures (7.3% vs 2.7%, p =0.01), particularly fractures of the tibia/fibula (5.6% vs 1.6%, p=0.008). No significant differences were found in the incidence of head, thoracolumbar, or pelvic fractures between the two groups. After controlling for age, gender, restraint use, and airbag deployment, obesity remained an independent predictor of lower extremity fracture (aOR) 2.62 (95% CI: 1.01-6.56), p = 0.04).</p><p><strong>Conclusion: </strong>Obesity is an independent predictor of lower extremity fractures following a MVA. Clinicians should acknowledge potential differences in fracture occurrence and patterns between obese and non-obese patients during triage.</p>\",\"PeriodicalId\":45096,\"journal\":{\"name\":\"Open Access Emergency Medicine\",\"volume\":\"17 \",\"pages\":\"185-193\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-05-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094485/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Access Emergency Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2147/OAEM.S490123\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Access Emergency Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/OAEM.S490123","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
目的：与非肥胖患者相比，肥胖创伤患者面临更高的死亡率、更长的ICU住院时间和更多的并发症。然而，一些研究表明，肥胖可能通过“缓冲效应”在高冲击创伤情况下提供保护作用。本研究将探讨肥胖是否会影响机动车事故（MVA）的骨折发生率、损伤严重程度和临床结果。方法：对2010-2022年期间在一级创伤中心接受MVA治疗的555名成年患者进行回顾性研究。体重指数（Body Mass Index， BMI）大于等于30 kg/m2的患者为肥胖（178例，32.6%），BMI小于30 kg/m2的患者为非肥胖（377例，67.4%）。采用损伤严重程度评分（ISS）和简易损伤量表（AIS）比较两组骨折发生率和损伤严重程度。对于单变量分析显著的变量，使用二元逻辑回归模型来控制年龄、性别、约束使用和安全气囊展开。结果：肥胖组和非肥胖组的平均骨折数（0.62 vs 0.46, p=0.096）和ISS （4.55 vs 4.51, p=0.703）相似。然而，肥胖患者更容易发生上肢骨折（7.3% vs 3.4%, p=0.045）和下肢骨折（7.3% vs 2.7%, p= 0.01），尤其是胫骨/腓骨骨折（5.6% vs 1.6%, p=0.008）。两组患者头部、胸腰椎或骨盆骨折的发生率无显著差异。在控制了年龄、性别、约束装置使用和安全气囊部署后，肥胖仍然是下肢骨折的独立预测因子（aOR） 2.62 (95% CI: 1.01-6.56), p = 0.04)。结论：肥胖是MVA后下肢骨折的独立预测因素。临床医生在分诊时应认识到肥胖和非肥胖患者骨折发生和模式的潜在差异。
Impact of Obesity on Orthopedic Injury and Fracture Patterns in Motor Vehicle Accidents.
Purpose: Obese trauma patients face a higher risk of mortality, prolonged ICU stays, and more complications than non-obese patients. However, some studies suggest that obesity might provide protective benefits in high-impact trauma situations through the "cushion effect". This study will examine whether obesity influences fracture occurrence, injury severity, and clinical outcomes in motor vehicle accidents (MVA).
Methods: A retrospective study of 555 adult patients who presented to a Level 1 Trauma Center following a MVA from 2010-2022. Patients with a Body Mass Index (BMI) greater than or equal to 30 kg/m2 were categorized as obese (178 patients, 32.6%), and those with a BMI less than 30 kg/m2 were classified as non-obese (377 patients, 67.4%). Incidence of bone fractures and injury severity were compared between both groups using injury severity score (ISS) and abbreviated injury scale (AIS). For variables significant on univariate analysis, binary logistic regression models were used to control age, gender, restraint use, and airbag deployment.
Results: The mean number of fractures (0.62 vs 0.46, p=0.096) and ISS (4.55 vs 4.51, p=0.703) were similar between the obese and non-obese groups. However, obese patients were more likely to experience upper extremity fractures (7.3% vs 3.4%, p=0.045) and lower extremity fractures (7.3% vs 2.7%, p =0.01), particularly fractures of the tibia/fibula (5.6% vs 1.6%, p=0.008). No significant differences were found in the incidence of head, thoracolumbar, or pelvic fractures between the two groups. After controlling for age, gender, restraint use, and airbag deployment, obesity remained an independent predictor of lower extremity fracture (aOR) 2.62 (95% CI: 1.01-6.56), p = 0.04).
Conclusion: Obesity is an independent predictor of lower extremity fractures following a MVA. Clinicians should acknowledge potential differences in fracture occurrence and patterns between obese and non-obese patients during triage.
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