Post-Procedure Outcomes of Obese Patients after Trauma Using a Large National Dataset

Background: Obesity is a chronic disease that is linked to unfavorable outcomes following hospital interventions. This study aimed to evaluate the relationship between increased BMI and adverse outcomes in the trauma population undergoing in hospital procedures. Methods: This retrospective cohort study utilized data from the Trauma Quality Program (TQP) Participant Use File (PUF) for 2020 and 2022. Adult trauma patients were stratified into six weight classes: underweight (BMI less than 18.5 kg/m2), healthy (BMI 18.5–25 kg/m2), overweight (BMI 25-30 kg/m2), class 1 obesity (BMI 30-34.9 kg/m2), class 2 obesity (BMI 35-39.9) and class 3 obesity (BMI greater than 40 kg/m2). Post-procedure complications and discharge disposition were compared between the groups. Results: The study included 598,894 trauma patients. Patients in the underweight group had the oldest average age (61.1 +/- 22.6 years, p<0.001) and less male patients (n=8350, 42.0%, p<0.001). Total length of stay was longest in the class 3 obesity group (145.5 +/- 202.1 inpatient hours, p<0.001). Underweight patients had the highest in-hospital mortality and were less likely to be discharged home from the hospital (p<0.001). On multivariate analysis, age was the only variable found to be associated with increased inpatient mortality (OR 1.020, 95% CI 1.019-1.02, p<0.001). Conclusion: Hospital length of stay was longest in post-procedure trauma patients with class 3 obesity. Underweight patients had the worst outcomes in terms of mortality and discharge disposition. Post-procedure intervention strategies targeting the extremes of weight are needed to improve recovery following procedures for these high-risk trauma patients.