Trauma
Abstracts
Sunit Dalal, MD
Saint Louis University School of Medicine
Background: Penetrating trauma to the chest and abdomen is a major cause of traumatic death. We have previously seen patients with a larger body mass index (BMI) do well after sustaining gunshot wound (GSW) injuries that did not penetrate the central chest or abdominal cavities. This study aimed to determine if patients with higher BMIs with isolated GSWs to the chest or abdomen were less likely to have a longer Intensive Care Unit (ICU) stay, or suffer mortality in the immediate post-GSW period than patients with a lower BMI.
Methods: We conducted a retrospective review of our trauma registry for patients seen between June 2012 and June 2017 who sustained GSW injuries to the chest, abdomen or pelvis. Only patients with completed BMI data were included. We divided these patients into those with a BMI of 25 or greater and those with a BMI of 24.9 or less. We collected the following data on these patients: length of EMS time-on-scene, type of penetrating trauma and location of such trauma, Injury Severity Score (ISS), length of ICU stay, and in-hospital mortality. We also noted which cases involved attempted suicide. Independent samples t-test, ANOVA, Pearson’s correlation and P-values were calculated.
Results: There were 2,715 total GSW cases in the trauma registry for patients seen between June 2012 and June 2017 that met criteria. Of this dataset, 528 of these cases had complete BMI data. There was no association between BMI and mortality, (p = 0.230). We also found no association between BMI and ICU stay (r = 0.067, p = 0.123). There was likewise no association between BMI and ISS (r = -0.049, p = 0.263). There was also no association between BMI and EMS time-on-scene (r = 0.062, p = 0.153). There were only 14 suicide patients in this subset, and there was no significant difference in BMI between these patients and non-suicidal patients (p = 0.215).
Conclusion: In patients who sustained GSW to their chest or abdomen, we found no association between BMI and ICU length of stay or in-hospital mortality.