gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Impact of Obesity in Traumatic Brain Injury

Meeting Abstract

  • Patrick Czorlich - Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurochirurgie, Hamburg, Deutschland
  • Pedram Emami - Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurochirurgie, Hamburg, Deutschland
  • Manfred Westphal - Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurochirurgie, Hamburg, Deutschland
  • Rolf Lefering - Institute for Research in Operative Medicine, Köln, Deutschland
  • Michael Hoffmann - Klinik für Orthopädie und Unfallchirurgie, Schön Klinik Neustadt, Neustadt in Holstein, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.24.06

doi: 10.3205/17dgnc320, urn:nbn:de:0183-17dgnc3206

Published: June 9, 2017

© 2017 Czorlich et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: Mortality and outcome in patients suffering from traumatic brain injury (TBI) is effected by many factors. One of these factors is the Body-Mass-Index (BMI) even if data on BMI and TBI are limited and for a severe obesity °II (BMI > 35 kg/m2) no data at all are existing. Aim of this study was to evaluate the impact of obesity in patients suffering from TBI.

Methods: A retrospective cohort analysis of patients suffering from severe TBI registered in the TraumaRegister DGU® of the German Trauma Society (DGU) from 2002 to 2009 was conducted. TBI was defined as an Abbreviated Injury Scale (AIS) in head of ≥3 and AIS in any other part of the body not exceeding the AIS of the head. The BMI was categorized in accordance with the WHO definition of obesity: Group: 1: BMI < 18.5 kg/m2, 2: BMI ≥ 18.5 kg/m2 - < 25 kg/m2, 3: BMI ≥ 25 kg/m2 - <30 kg/m2, 4: BMI ≥ 30 kg/m2 - < 35 kg/m2 (Obesity° I) and 5: BMI ≥ 35 kg/m2 (Obesity °II). The evaluation included preclinical data, initial treatment in the emergency room (ER), clinical course and mortality in relation to the BMI.

Results: 1714 patients with complete datasets fulfilled the inclusion criteria. In 49 patients the BMI was lower than 18.5 kg/m2, 885 patients presented with a normal weight (BMI ≥ 18.5 kg/m2 - < 25 kg/m2), 604 patients presented with overweight (≥ 25 kg/m2 - <30 kg/m2), while 137 patients suffered from obesity °I (BMI ≥ 30 kg/m2 - < 35 kg/m2) and 39 patients from a severe obesity ≥ °II (BMI > 35 kg/m2). Patients with obesity °I und °II were predominately male (75.9%, respectively 74.4%, p<0.001), older (p<0.001) and TBI was associated with traffic accidents (p<0.001). A Glasgow Coma Scale (GCS) ≤ 8 was less often recorded in obesity °I and II (p=0.005). Multivariate logistic regression analysis demonstrated that a BMI > 35 kg/m2 was associated with a higher mortality risk (Odds ratio (OR) 3.219; 95% Confidence interval (95%CI) [1.073-9.655)], p=0.037). A GCS 3-8 (OR 5.802; 95%CI [3.007-11.196] p<0.001), preclinical cardiopulmonary resuscitation (OR 10.815; 95%CI [4.455-26.257] p<0.001), a systolic blood pressure < 90mmHg (OR 1.976; 95%CI [1.268-3.079] p=0.003) and an increasing severity of the TBI were associated with a higher mortality. A BMI of ≥ 25 kg/m2 - <30 kg/m2 had no impact on the mortality rate (OR 0.788; 95%CI [0.531-1.170] p=0.238).

Conclusion: A BMI > 35 kg/m2 in patients suffering from TBI seems to be associated with a higher mortality.