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The weight of obesity in patients with lower extremity vascular injuries
Authors:Jon D. Simmons  Juan C. Duchesne  Naveed Ahmed  Robert E. Schmieg  Fred W. Rushton  John M. Porter  Marc E. Mitchell
Affiliation:1. Department of Gynecology and Obstetrics, Emory University School of Medicine, Winship Cancer Institute, United States of America;2. Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States of America;3. Department of Obstetrics and Gynecology, The Mount Sinai Hospital, New York, NY, United States of America;4. School of Public Health, State University of New York Downstate Medical Center, Brooklyn, NY, United States of America;5. Department of Surgery, Division of Gynecologic Oncology, City of Hope National Medical Center Duarte, CA, United States of America
Abstract:ObjectiveClinical obesity is an epidemic problem in the United States. The impact of this disease upon traumatic lower extremity vascular injuries (LEVI) is as yet undefined. We hypothesized that clinical obesity adversely affects outcome in patients with traumatic LEVI.MethodsAll adult patients admitted over a 5-year period with a traumatic LEVI were identified. Clinical obesity was defined as body mass index (BMI) > 30. Obese and non-obese patient groups were compared for surgical management and outcome.ResultsA total of 145 patients were identified. BMI data were available for 115 (79.3%) of these patients (obese n = 47; non-obese n = 68). Obese and non-obese groups were similar. Obese patients underwent more vascular repairs but the amputation rate and mortality were not significantly different.ConclusionsWhile obese body habitus can increase the complexity of evaluation and management of patients with LEVI, we have demonstrated that equivalent outcomes to the non-obese population can be achieved for the clinically obese patient with a BMI > 30. However, patients with a BMI > 40 did reveal a significantly higher chance of amputation and death after LEVI. Due to the small number of patients in this subset, one should use caution when interpreting this data.
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