1. 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

2. 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

3. 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%

4. 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%

5. 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%

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

8. Methods Retrospective Cohort Study WVU Trauma Database from 2009-2010 All Consecutive Adult Trauma Admissions –3180 total 2 Cohorts –Obese, Non-Obese

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

10. 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

11. 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

12. BMI < 30BMI > 30 n21391042 Age43.0247.11 Weight (kg)72.94104.91 BMI2436 Demographic Data Results

13. Results BMI < 30BMI > 30P Value Mortality (%) 1.72.2>0.05 ICU (hours) 28.840.80.001 Hospital (days) 4.150.002 Vent (hours) 14.4240.002

14. Results BMI < 30BMI > 30P Value AIS320.001 ISS11.210.50.039 Workers Comp Claims (%) 5.86.80.039 Require inpatient rehab (%) 570.002 Charges$35,302$43,2620.001

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