2019 Trauma/Critical Care Presentations

Kelli Ishihara, MD, Grant Sizemore, MD, Scott Nguyen, MD, Freeman Condon, MD, Bridgette Colgan, MD, John Mayo, Erik Criman, Dylan Russell, Mike Lustik, MS, Robert Lim, MD; Tripler Army Medical Center

Introduction: The Joint Theater Trauma Registry (JTTR) has recorded 1239 individuals in the United States Armed Forces who sustained a combat-related amputation during the Global War on Terror. Anecdotal data shows combat-related amputees develop obesity and cardiovascular disease, but the incidence of obesity in this population is unknown.  Amputation even in healthy populations may lead to obesity and obesity related comorbidities. The objectives of this study are to determine the prevalence of obesity in the military amputee population and to compare this to the general population.

Methods: This is a retrospective review of 964 patients. The JTTR was scanned to identify all surviving patients with a combat-related amputation from 2001-2015.  Patients were then identified in their military medical records to obtain height, weight, and medical co-morbidities before and after their injuries. Prevalence of obesity (BMI > 30) and comorbid conditions were determined. A corrected BMI formula for amputees was used. Logistic regression models were utilized to identify variables associated with the development of obesity.

Results: A total of 1214 charts were reviewed with 964 patients included for analysis. The average age at injury was 25.0 years with a mean follow-up of 7.8 years. The prevalence of obesity pre-injury was 12.8% versus 46% post-injury based on most recent BMI. The average BMI pre-injury was 26.2 kg/m2, while average current BMI was found to be 30.8 kg/m2 when using the corrected BMI formula. Logistic regression models demonstrated that those with lower extremity amputations were more likely to be obese.

Conclusion: Results of the study demonstrate that there is a notable prevalence of obesity that develops in the amputee population that is much higher than the general population. The amputee population appears to be an at-risk population and these patients should be monitored for the development of obesity associated conditions.