Hips don't lie

Waist-to-hip ratio in trauma patients

Bellal Joseph, Bardiya Zangbar, Ansab Abbas Haider, Naroung Kulvatunyou, Mazhar Khalil, Andrew Tang, Terence OKeeffe, Randall S. Friese, Tahereh Orouji Jokar, Gary Vercruysse, Rifat Latifi, Peter Rhee

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

BACKGROUND Obesity measured by body mass index (BMI) is known to be associated with worse outcomes in trauma patients. Recent studies have assessed the impact of distribution of body fat measured by waist-hip ratio (WHR) on outcomes in nontrauma patients. The aim of this study was to assess the impact of distribution of body fat (WHR) on outcomes in trauma patients. METHODS A 6-month (June to November 2013) prospective cohort analysis of all admitted trauma patients was performed at our Level 1 trauma center. WHR was measured in each patient on the first day of hospital admission. Patients were stratified into two groups: patients with WHR of 1 or greater and patients with WHR of less than 1. Outcome measures were complications and in-hospital mortality. Complications were defined as infectious, pulmonary, and renal complications. Regression and correlation analyses were performed. RESULTS A total of 240 patients were enrolled, of which 28.8% patients (n = 69) had WHR of 1 or greater. WHR had a weak correlation with BMI (R2 = 0.231, R = 0.481). Eighteen percent (n = 43) of the patients developed complications, and the mortality rate was 10% (n = 24). Patients with a WHR of 1 or greater were more likely to develop in-hospital complications (32% vs. 13%, p = 0.001) and had a higher mortality rate (24% vs. 4%, p = 0.001) compared with the patients with a WHR of less than 1. In multivariate analysis, a WHR of 1 or greater was an independent predictor for the development of complications (odds ratio, 3.1; 95% confidence interval 1.08-9.2; p = 0.03) and mortality (odds ratio, 13.1; 95% confidence interval, 1.1-70; p = 0.04). CONCLUSION Distribution of body fat as measured by WHR independently predicts mortality and complications in trauma patients. WHR is better than BMI in predicting adverse outcomes in trauma patients. Assessing the fat distribution pattern in trauma patients may help improve patient outcomes through focused targeted intervention. LEVEL OF EVIDENCE Prognostic study, level II.

Original languageEnglish (US)
Pages (from-to)1055-1061
Number of pages7
JournalJournal of Trauma and Acute Care Surgery
Volume79
Issue number6
DOIs
StatePublished - Dec 1 2015
Externally publishedYes

Fingerprint

Waist-Hip Ratio
Hip
Wounds and Injuries
Body Fat Distribution
Body Mass Index
Mortality
Odds Ratio
Confidence Intervals
Trauma Centers
Hospital Mortality

Keywords

  • body mass index
  • complications
  • trauma
  • waist circumference
  • Waist-to-hip ratio

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Joseph, B., Zangbar, B., Haider, A. A., Kulvatunyou, N., Khalil, M., Tang, A., ... Rhee, P. (2015). Hips don't lie: Waist-to-hip ratio in trauma patients. Journal of Trauma and Acute Care Surgery, 79(6), 1055-1061. https://doi.org/10.1097/TA.0000000000000876

Hips don't lie : Waist-to-hip ratio in trauma patients. / Joseph, Bellal; Zangbar, Bardiya; Haider, Ansab Abbas; Kulvatunyou, Naroung; Khalil, Mazhar; Tang, Andrew; OKeeffe, Terence; Friese, Randall S.; Orouji Jokar, Tahereh; Vercruysse, Gary; Latifi, Rifat; Rhee, Peter.

In: Journal of Trauma and Acute Care Surgery, Vol. 79, No. 6, 01.12.2015, p. 1055-1061.

Research output: Contribution to journalArticle

Joseph, B, Zangbar, B, Haider, AA, Kulvatunyou, N, Khalil, M, Tang, A, OKeeffe, T, Friese, RS, Orouji Jokar, T, Vercruysse, G, Latifi, R & Rhee, P 2015, 'Hips don't lie: Waist-to-hip ratio in trauma patients', Journal of Trauma and Acute Care Surgery, vol. 79, no. 6, pp. 1055-1061. https://doi.org/10.1097/TA.0000000000000876
Joseph B, Zangbar B, Haider AA, Kulvatunyou N, Khalil M, Tang A et al. Hips don't lie: Waist-to-hip ratio in trauma patients. Journal of Trauma and Acute Care Surgery. 2015 Dec 1;79(6):1055-1061. https://doi.org/10.1097/TA.0000000000000876
Joseph, Bellal ; Zangbar, Bardiya ; Haider, Ansab Abbas ; Kulvatunyou, Naroung ; Khalil, Mazhar ; Tang, Andrew ; OKeeffe, Terence ; Friese, Randall S. ; Orouji Jokar, Tahereh ; Vercruysse, Gary ; Latifi, Rifat ; Rhee, Peter. / Hips don't lie : Waist-to-hip ratio in trauma patients. In: Journal of Trauma and Acute Care Surgery. 2015 ; Vol. 79, No. 6. pp. 1055-1061.
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abstract = "BACKGROUND Obesity measured by body mass index (BMI) is known to be associated with worse outcomes in trauma patients. Recent studies have assessed the impact of distribution of body fat measured by waist-hip ratio (WHR) on outcomes in nontrauma patients. The aim of this study was to assess the impact of distribution of body fat (WHR) on outcomes in trauma patients. METHODS A 6-month (June to November 2013) prospective cohort analysis of all admitted trauma patients was performed at our Level 1 trauma center. WHR was measured in each patient on the first day of hospital admission. Patients were stratified into two groups: patients with WHR of 1 or greater and patients with WHR of less than 1. Outcome measures were complications and in-hospital mortality. Complications were defined as infectious, pulmonary, and renal complications. Regression and correlation analyses were performed. RESULTS A total of 240 patients were enrolled, of which 28.8{\%} patients (n = 69) had WHR of 1 or greater. WHR had a weak correlation with BMI (R2 = 0.231, R = 0.481). Eighteen percent (n = 43) of the patients developed complications, and the mortality rate was 10{\%} (n = 24). Patients with a WHR of 1 or greater were more likely to develop in-hospital complications (32{\%} vs. 13{\%}, p = 0.001) and had a higher mortality rate (24{\%} vs. 4{\%}, p = 0.001) compared with the patients with a WHR of less than 1. In multivariate analysis, a WHR of 1 or greater was an independent predictor for the development of complications (odds ratio, 3.1; 95{\%} confidence interval 1.08-9.2; p = 0.03) and mortality (odds ratio, 13.1; 95{\%} confidence interval, 1.1-70; p = 0.04). CONCLUSION Distribution of body fat as measured by WHR independently predicts mortality and complications in trauma patients. WHR is better than BMI in predicting adverse outcomes in trauma patients. Assessing the fat distribution pattern in trauma patients may help improve patient outcomes through focused targeted intervention. LEVEL OF EVIDENCE Prognostic study, level II.",
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AU - Khalil, Mazhar

AU - Tang, Andrew

AU - OKeeffe, Terence

AU - Friese, Randall S.

AU - Orouji Jokar, Tahereh

AU - Vercruysse, Gary

AU - Latifi, Rifat

AU - Rhee, Peter

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N2 - BACKGROUND Obesity measured by body mass index (BMI) is known to be associated with worse outcomes in trauma patients. Recent studies have assessed the impact of distribution of body fat measured by waist-hip ratio (WHR) on outcomes in nontrauma patients. The aim of this study was to assess the impact of distribution of body fat (WHR) on outcomes in trauma patients. METHODS A 6-month (June to November 2013) prospective cohort analysis of all admitted trauma patients was performed at our Level 1 trauma center. WHR was measured in each patient on the first day of hospital admission. Patients were stratified into two groups: patients with WHR of 1 or greater and patients with WHR of less than 1. Outcome measures were complications and in-hospital mortality. Complications were defined as infectious, pulmonary, and renal complications. Regression and correlation analyses were performed. RESULTS A total of 240 patients were enrolled, of which 28.8% patients (n = 69) had WHR of 1 or greater. WHR had a weak correlation with BMI (R2 = 0.231, R = 0.481). Eighteen percent (n = 43) of the patients developed complications, and the mortality rate was 10% (n = 24). Patients with a WHR of 1 or greater were more likely to develop in-hospital complications (32% vs. 13%, p = 0.001) and had a higher mortality rate (24% vs. 4%, p = 0.001) compared with the patients with a WHR of less than 1. In multivariate analysis, a WHR of 1 or greater was an independent predictor for the development of complications (odds ratio, 3.1; 95% confidence interval 1.08-9.2; p = 0.03) and mortality (odds ratio, 13.1; 95% confidence interval, 1.1-70; p = 0.04). CONCLUSION Distribution of body fat as measured by WHR independently predicts mortality and complications in trauma patients. WHR is better than BMI in predicting adverse outcomes in trauma patients. Assessing the fat distribution pattern in trauma patients may help improve patient outcomes through focused targeted intervention. LEVEL OF EVIDENCE Prognostic study, level II.

AB - BACKGROUND Obesity measured by body mass index (BMI) is known to be associated with worse outcomes in trauma patients. Recent studies have assessed the impact of distribution of body fat measured by waist-hip ratio (WHR) on outcomes in nontrauma patients. The aim of this study was to assess the impact of distribution of body fat (WHR) on outcomes in trauma patients. METHODS A 6-month (June to November 2013) prospective cohort analysis of all admitted trauma patients was performed at our Level 1 trauma center. WHR was measured in each patient on the first day of hospital admission. Patients were stratified into two groups: patients with WHR of 1 or greater and patients with WHR of less than 1. Outcome measures were complications and in-hospital mortality. Complications were defined as infectious, pulmonary, and renal complications. Regression and correlation analyses were performed. RESULTS A total of 240 patients were enrolled, of which 28.8% patients (n = 69) had WHR of 1 or greater. WHR had a weak correlation with BMI (R2 = 0.231, R = 0.481). Eighteen percent (n = 43) of the patients developed complications, and the mortality rate was 10% (n = 24). Patients with a WHR of 1 or greater were more likely to develop in-hospital complications (32% vs. 13%, p = 0.001) and had a higher mortality rate (24% vs. 4%, p = 0.001) compared with the patients with a WHR of less than 1. In multivariate analysis, a WHR of 1 or greater was an independent predictor for the development of complications (odds ratio, 3.1; 95% confidence interval 1.08-9.2; p = 0.03) and mortality (odds ratio, 13.1; 95% confidence interval, 1.1-70; p = 0.04). CONCLUSION Distribution of body fat as measured by WHR independently predicts mortality and complications in trauma patients. WHR is better than BMI in predicting adverse outcomes in trauma patients. Assessing the fat distribution pattern in trauma patients may help improve patient outcomes through focused targeted intervention. LEVEL OF EVIDENCE Prognostic study, level II.

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KW - complications

KW - trauma

KW - waist circumference

KW - Waist-to-hip ratio

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