The weighty issue: the impact of Body Mass Index (BMI) in Asian trauma patients

Background:The controversy surrounding the impact of Body Mass Index (BMI) on the outcome of trauma patients has been widely studied in the West. However, no such studies have looked at an Asian trauma population. The aim of our study was to investigate the impact of BMI on mortality, morbidity, severity and pattern of injury in trauma patients of multicultural Singapore. Methods: In this prospective study, we recruited all trauma patients admitted to Tan Tock Seng Hospital over a 13 month period. Both the international World Health Organization (WHO) and Asian modified classifications of BMI were used for the purpose of our study. Patient demographics, co-morbidities, mechanism of injury, injury severity score (ISS), body regions injured, morbidity and mortality were collected using inpatient medical records. Results: 964 patients with a mean age of 50.5 years were recruited. Majority of injuries sustained were due to falls. There was no association between Asian BMI and ISS. Head, neck and cervical injuries occurred less commonly in the overweight and obese group, but BMI does not confer protection from truncal injury. BMI was not a significant risk factor for morbidity or mortality. Conclusion: Being overweight does not appear to increase severity of injury in Asian trauma patients. BMI as an independent risk factor does not contribute to trauma mortality or morbidity. We conclude that BMI is not a significant contributing factor to adverse trauma outcomes in Asians. (Hong Kong j.emerg.med. 2012;19:312-318)