背景:关于体重指数(BMI)之间的关系知之甚少,创伤幸存者的质量和身高(masskg/height2m)以及长期结局的函数。在这项前瞻性队列研究中,我们调查了创伤人群BMI与长期健康结局之间的关系.
方法:受伤严重程度评分≥9分的成年创伤幸存者入住三个一级创伤中心之一,从2015年1月1日至2022年12月31日,在受伤后6至12个月之间通过电话进行了调查。根据创伤时的BMI将参与者分为五组之一:L-BMI(BMI<18.5),N-BMI(BMI18.5-24.9),H1-BMI(BMI25-29.9),H2-BMI(BMI30-34.9),和H3-BMI(BMI≥35);N-BMI用作参考。精神和身体健康相关的生活质量评分,疼痛,新的功能限制,并评估了再入院率.使用单变量和多变量分析比较研究组之间的结果。
结果:纳入3830例患者。其中,124为L-BMI(3.2%),1495N-BMI(39%),1318H1-BMI(34.4%),541H2-BMI(14.1%),和352H3-BMI(9.2%)。L-BMI与伤后6-12个月的不良身体(b=-3.13,CI=-5.71至-0.55,P=0.017)和心理健康(b=-3.17,CI=-5.87至-0.46,P=0.022)结果相关。H1-BMI和H2-BMI具有较高的物理结果(b=-1.47,CI=-2.42至-0.52,P=0.002;b=-3.11,CI=-4.33至-1.88,P≤0.001,分别)和慢性疼痛(调整比值比(aOR)=1.24,CI=1.04-1.47,P=0.016;aOR=1.52,CI=1.21与N-BMI相比,H3-BMI患者的身体预后较差的可能性更高(b=-4.82,CI=-6.28至-3.37,P≤0.001),慢性疼痛(aOR=2.11,CI=1.61-2.78,P≤0.001),全因再入院(aOR=1.62,CI=1.10-2.34,P=0.013),和新的功能限制(aOR=1.39,CI=1.08-1.79,P=0.01)。
结论:BMI方差高于或低于N-BMI与创伤性损伤后较差的长期预后相关。
BACKGROUND: Little is known about the relationship between body mass index (BMI), a function of mass and height (masskg/height2m) and long-term outcomes among traumatic injury survivors. In this prospective cohort study, we investigate the relationship between BMI and long-term health outcomes in the trauma population.
METHODS: Adult trauma survivors with an injury severity score ≥9 admitted to one of three level 1 trauma centers, from January 1, 2015 to December 31, 2022, were surveyed via telephone between 6 and 12 mo postinjury. Participants were stratified into one of five groups by BMI at the time of trauma: L-BMI (BMI <18.5), N-BMI (BMI 18.5-24.9), H1-BMI (BMI 25-29.9), H2-BMI (BMI 30-34.9), and H3-BMI (BMI ≥35); N-BMI was used as the referent. Mental and physical health-related quality of life scores, pain, new functional limitations, and hospital readmissions were evaluated. Univariate and multivariate analyses were used to compare outcomes between study groups.
RESULTS: 3830 patients were included. Of those, 124 were L-BMI (3.2%), 1495 N-BMI (39%), 1318 H1-BMI (34.4%), 541 H2-BMI (14.1%), and 352 H3-BMI (9.2%). L-BMI was associated with adverse physical (b = -3.13, CI = -5.71 to -0.55, P = 0.017) and mental health (b = -3.17, CI = -5.87 to -0.46, P = 0.022) outcomes 6-12 mo postinjury compared to the referent. H1-BMI and H2-BMI had higher odds of wo`rse physical outcomes (b = -1.47, CI = -2.42 to -0.52, P = 0.002; b = -3.11, CI = - 4.33 to -1.88, P ≤ 0.001, respectively) and chronic pain (adjusted odds ratio (aOR) = 1.24, CI = 1.04-1.47, P = 0.016; aOR = 1.52, CI = 1.21-1.90, P ≤ 0.001, respectively). Patients with H3-BMI had higher odds of worse physical outcomes compared to N-BMI (b = -4.82, CI = -6.28 to -3.37, P ≤ 0.001), chronic pain (aOR = 2.11, CI = 1.61-2.78, P ≤ 0.001), all-cause hospital readmissions (aOR = 1.62, CI = 1.10-2.34, P = 0.013), and new functional limitations (aOR = 1.39, CI = 1.08-1.79, P = 0.01).
CONCLUSIONS: BMI variance above or below N-BMI is associated with worse long-term outcomes following traumatic injury.