The Relationship Between Body Mass Index and Abdominal Circumference with Intraabdominal Organ Injury in High Energy Blunt Abdominal Trauma

Year 2024, Volume: 7 Issue: 3, 121 - 126, 28.09.2024

Alper Üzülmez , Ayhan Özhasenekler , Esra Çıvgın , Alp Şener , Mehmet Ergin , Şervan Gökhan

https://doi.org/10.54996/anatolianjem.1477433

Abstract

Aim: The aim of this study was to determine the impact of body mass index (BMI) and abdominal circumference on intra-abdominal organ injury in high energy blunt trauma patients presenting to the emergency department.

Material and Methods: This prospective, cross-sectional, and analytical study included patients who presented to the Ankara Bilkent City Hospital Emergency Medicine Clinic between June 15, 2022, and December 31, 2022, due to high-energy blunt trauma and underwent contrast-enhanced abdominal computed tomography (CT). Patient demographics, vital signs, height, weight, BMI, mechanism of injury, abdominal injuries, injuries to other systems, abdominal circumference measurements, emergency department outcomes, and laboratory results were recorded in the data collection form. CT images were evaluated by a single radiology specialist, and abdominal circumference and subcutaneous fat tissue thickness were measured.

Results: A total of 374 patients were included in the study. 71.9% of the patients were male (n=269). The average age of the patients was 40 ± 16 years. Intra-abdominal injury was observed most frequently (30.8%) in patients with a BMI <18.5 (p=0.017). Although patients with intra-abdominal injury had lower sagittal abdominal diameter (SAD), transverse external diameter (T-ext), subcutaneous fat (Sc-fat), and BMI averages, these findings were not statistically significant (p=0.321, p=0.666, p=0.172, p=0.595, respectively). Patients admitted to the intensive care unit had lower SAD (20.6 ± 4.0 cm), T-ext (30.7 ± 3.9 cm), Sc-fat (2.0 ± 1.0 cm), and BMI (24.9 ± 4.4 kg/m2) averages (p=0.003, p=0.009, p=0.006, p=0.007, respectively).

Conclusion: Patients with a BMI <18.5 were found to be more susceptible to intra-abdominal injury. Patients with lower abdominal circumference (SAD, T-ext), Sc-fat, and BMI values were more likely to be admitted to the intensive care unit. Therefore, it is important to be cautious regarding abdominal injuries and injuries requiring intensive care admission in underweight and normal-weight patients who have experienced high-energy blunt trauma.

Keywords

High energy, blunt abdominal trauma, body mass index, abdominal circumference, subcutaneous fat thickness, emergency medicine

Ethical Statement

I declare that this study is an original work, and I have adhered to the scientific ethical principles and rules at all stages of preparation, data collection, analysis, and presentation of information. I acknowledge that for all data and information not obtained within the scope of this study, I have provided proper attribution to the sources used, and I have included these sources in the references. I confirm that no alterations have been made to the data used, and I abide by the ethical duties and responsibilities by accepting all terms and conditions of the Committee on Publication Ethics (COPE). I hereby state that I am aware and consent to all moral and legal consequences that may arise if any discrepancy with this declaration regarding the study is identified at any time.

Supporting Institution

The study received no financial support.

Thanks

I would like to thank my esteemed professors for their efforts during my assistantship process and for their contributions to this article.

Yüksek Enerjili Künt Karın Travmalarında Vücut Kitle İndeksi ve Karın Çevresi ile Karın İçi Organ Yaralanması Arasındaki İlişki

Abstract

Amaç: Bu çalışmanın amacı, acil servise başvuran yüksek enerjili künt travma hastalarında vücut kitle indeksi (VKİ) ve karın çevresinin karın içi organ yaralanması üzerindeki etkisini belirlemektir.

Gereç ve Yöntemler: Bu prospektif, kesitsel ve analitik çalışmaya, 15 Haziran 2022 ile 31 Aralık 2022 tarihleri arasında Ankara Bilkent Şehir Hastanesi Acil Tıp Kliniğine yüksek enerjili künt travma nedeniyle başvuran ve kontrastlı abdominal bilgisayarlı tomografi (BT) çekilen hastalar dahil edilmiştir. Hastaların demografik bilgileri, yaşamsal bulguları, boy, kilo, VKİ, yaralanma mekanizması, karın yaralanmaları, diğer sistem yaralanmaları, karın çevresi ölçümleri, acil servis sonlanımı ve laboratuvar sonuçları veri toplama formuna kaydedildi. BT görüntüleri tek bir radyoloji uzmanı tarafından değerlendirildi, karın çevresi ve deri altı yağ dokusu kalınlığı ölçüldü.

Bulgular: Çalışmaya toplam 374 hasta dahil edilmiştir ve %71,9'u (n=269) erkektir. Hastaların yaş ortalaması 40 ± 16 idi. İntraabdominal yaralanma en sık (%30,8) VKİ <18,5 olan hastalarda gözlendi (p=0,017). Karın içi yaralanması olan hastaların sagittal karın çapı (SKÇ), transvers dış çapı (TDÇ), deri altı yağ ve VKİ ortalamaları daha düşük olmasına rağmen, bu bulgular istatistiksel olarak anlamlı değildi (sırasıyla p=0.321, p=0.666, p=0.172, p=0.595). Yoğun bakım ünitesine kabul edilen hastaların SKÇ (20,6 ± 4,0 cm), TDÇ (30,7 ± 3,9 cm), deri altı yağ (2,0 ± 1,0 cm) ve VKİ (24,9 ± 4,4 kg/m2) ortalamaları daha düşüktü (sırasıyla p=0,003, p=0,009, p=0,006, p=0,007).

Sonuç: VKİ <18,5 olan hastalar karın içi yaralanmaya daha yatkın bulundu. Daha düşük karın çevresi (SKÇ, TDÇ), deri altı yağ ve VKİ değerlerine sahip hastaların yoğun bakım ünitesine kabul edilme olasılığı daha yüksekti. Bu nedenle, yüksek enerjili künt travma geçiren zayıf ve normal kilolu hastalarda karın yaralanmaları ve yoğun bakıma yatış gerektiren yaralanmalar konusunda dikkatli olmak önemlidir.

Keywords

Yüksek enerji, künt karın travması, vücut kitle endeksi, karın çevresi, cilt altı yağ doku kalınlığı, acil servis

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