Obesity and short-term outcomes in blunt liver trauma with and without surgical repair: evidence from the United States Nationwide Inpatient Sample 2005-2020.

BACKGROUND: To determine the influence of obesity on short-term outcomes in patients with blunt liver trauma. METHODS: The US Nationwide Inpatient Sample (NIS) database 2005-2020 was reviewed to identify patients ≥ 18 years old with blunt liver trauma. Patients were categorized based on body mass index (BMI) into morbidly obese (BMI > 40 kg/m2), obese (30 ≤ BMI ≤ 40 kg/m2), and non-obese (BMI < 30 kg/m2) groups. RESULTS: A total of 4121 patients were included, representing an estimated 20,382 patients nationwide. The mean age was 46.4 years, and 51.0% were male. Both obese and morbidly obese patients had significantly increased risks of in-hospital mortality (obese: adjusted odds ratio [aOR] = 1.59, 95% confidence interval [CI] 1.05-2.14; morbidly obese: aOR = 2.43, 95% CI 1.61-3.65). Morbid obesity was associated with increased risks of acute kidney injury (AKI) (aOR = 1.90, 95% CI 1.50-2.41) and shock (aOR = 1.56, 95% CI 1.21-2.01). However, patients with non-morbid obesity had significantly lower risks of prolonged LOS (aOR = 0.61, 95% CI 0.50-0.75), non-routine discharge (aOR = 0.66, 95% CI 0.53-0.81), and complications (aOR = 0.69, 95% CI: 0.57-0.83) compared to non-obese individuals. CONCLUSION: Patients with morbid obesity who sustain blunt liver trauma are at increased risk of in-hospital mortality, AKI, and shock compared to non-obese individuals. Despite higher mortality risk, non-morbid obese patients have a lower risk of prolonged LOS, non-routine discharges, and complications.