Infectious complications in obese patients after trauma.

BACKGROUND: Obesity is a public health concern in the United States due to its increasing prevalence, especially in younger age groups. Trauma is the most common cause of death for people under aged 40 y. The purpose of this study is to determine the association between obesity and specific infectious complications after traumatic injury. MATERIALS AND METHODS: A retrospective analysis was conducted using data from the 2012 National Trauma Data Bank. The National Trauma Data Bank defined obesity as having a body mass index of 30 or greater. Descriptive statistics were calculated and stratified by obesity status. A hierarchical regression model was used to determine the odds of experiencing an infectious complication in patients with obesity while controlling for age, gender, diabetes, number of comorbidities, injury severity, injury mechanism, head injury, and surgical procedure. RESULTS: Patients with a body mass index of 30 or greater compared with nonobese patients had increased odds of having an infectious complication (Odds Ratio, 1.59; 1.49-1.69). In addition to obesity, injury severity score greater than 29, age 40 y or older, diabetes, comorbid conditions, and having a surgical procedure were also predictive of an infectious complication. CONCLUSIONS: Our results indicate that trauma patients with obesity are nearly 60% more likely to develop an infectious complication in the hospital. Infection prevention and control measures should be implemented soon after hospital arrival for patients with obesity, particularly those with operative trauma.

Trends in Emergency Department Visits for Nonfatal Violence-Related Injuries Among Adolescents in the United States, 2009-2013.

PURPOSE: Violence-related injuries are a major cause of death and disability among adolescents in the United States. The objective of this study was to examine trends in adolescent violence-related injuries between 2009 and 2013. METHODS: This study examined data from the National Electronic Injury Surveillance System-All Injury Program for years 2009-2013. Linear regression was used to assess trends in rates of violence-related injuries among adolescents aged between 10 and 19 years. RESULTS: We found overall rates of nonfatal violence-related injuries among all adolescents did not change significantly across the study years (p = .502). However, self-harm injury rates have significantly increased among female and younger adolescents during the period (p = .001 and .011, respectively). CONCLUSIONS: Our results indicate that the overall intentional injury rates in adolescents have been stable; however, rates of self-injury have significantly increased in younger adolescents and females. Future research should focus on exploring causes of increases in self-harm injuries in these subpopulations.