The impact of body mass index on the development of systemic inflammatory response syndrome and sepsis in patients with polytrauma

PurposeObesity is a growing problem in industrial nations. Our aim was to examine how overweight patients coped with systemic inflammatory response syndrome (SIRS) after polytrauma.MethodsA total of 651 patients were included in this retrospective study, with an ISS ≥ 16 and age ≥ 16 years. The sample was subdivided into three groups: body mass index (BMI; all in kg/m2) < 25, BMI 25–30 and BMI > 30, or low, intermediate and high BMI. The SIRS score was measured over 31 days after admission together with measurements of C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT). Data are given as the mean ± SEM if not otherwise indicated. Kruskal–Wallis and χ2 tests were used for statistical analysis and the significance level was set at p < .05.ResultsThe maximum SIRS score was reached in the low BMI-group at 3.4 ± 0.4, vs. 2.3 ± 0.1 and 2.5 ± 0.2 in the intermediate BMI-group and high BMI-group, respectively (p < .0001). However, the maximum SIRS score was reached earlier in the BMI 25–30 group at 1.8 ± 0.2 days, vs. 3.4 ± 0.4 and 2.5 ± 0.2 days in the BMI < 25 and BMI > 30 groups, respectively (p < .0001). The incidence of sepsis was significantly higher in the low BMI group at 46.1%, vs. 0.2% and 0% in the BMI 25–30 and BMI > 30 groups, respectively (p < .0001). No significant differences in the CRP, IL-6 or PCT levels were found between groups.ConclusionsA higher BMI seemed to be protective for these patients with polytrauma-associated inflammatory problems.