The Heavy Burden of Obesity on Trauma Care in West Virginia Jason Turner MD, Jennifer Knight MD, Fawad Khan MD, Glenn Warden MD, Jane Channel RN, Alison Wilson MD, Gregory Schaefer DO Jason Turner MD, Jennifer Knight MD, Fawad Khan MD, Glenn Warden MD, Jane Channel RN, Alison Wilson MD, Gregory Schaefer DO WVU Hospitals Jon Michael Moore Trauma Center West Virginia University Department of Surgery Division of Trauma and Critical Care

Relavance to West Virginia Obesity- West Virginia is #1 34% of West Virginians are Obese –33% of Adult Trauma admission at the JMMTC are Obese Prevalence of Obesity is increasing Trauma is the leading cause of death in people ages 1 to 45

Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1992 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1999 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 2009 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Purpose To evaluate the impact of obesity on outcomes in trauma patients –Demographic –Clinical –Social –Financial

Methods Retrospective Cohort Study WVU Trauma Database from All Consecutive Adult Trauma Admissions –3180 total 2 Cohorts –Obese, Non-Obese

Cohort Comparison Obese (OB, BMI ≥ 30 Kg/m2) –1042 patients Non-Obese (NO, BMI < 30 Kg/m2) –2138 patients

Cohort Comparison Obese vs. Non-Obese –Mortality –ICU Days –Hospital Days –Ventilator Days –ISS –AIS –Cost of Care –Need for inpatient rehab –Workers Comp Claim Submissions

Statistical Analysis Univariate analysis was performed on all data sets –Students t test used for outcome variables –Chi-Squared test used for Categorical variables p< 0.05

BMI < 30BMI > 30 n Age Weight (kg) BMI2436 Demographic Data Results

Results BMI < 30BMI > 30P Value Mortality (%) >0.05 ICU (hours) Hospital (days) Vent (hours)

Results BMI < 30BMI > 30P Value AIS ISS Workers Comp Claims (%) Require inpatient rehab (%) Charges$35,302$43,

Discussion MortalityMorbidity Inherent Challenges Cost –Primary –Secondary HospitalPersonalEmployer Trauma Outcome Measures Future