Clinical Outcomes in the Patient With Traumatic Brain Injury and Comorbid Obesity: A Scoping Review.

Abstract

Very few studies exist examining the effects of mild traumatic brain injury (mTBI) in patients with obesity, which is notable given that mTBI represents ~80% of all recorded TBIs. Given that approximately 40% of US adults have an obese body mass index (with predictions that this proportion will continue to increase), it would be prudent to focus efforts on targeted treatments for this growing subpopulation of patients with TBI. Authors have postulated that higher preinjury inflammation, as observed in the patient with obesity, could lead to greater spikes in acute inflammation following traumatic brain injury and higher chances of prolonged inflammation. Evidence to support this hypothesis has emerged recently, but this body of research has limitations such as evaluating TBI outcomes at variable timepoints along with an underappreciation of the heterogeneity of TBI outcomes. Our goal was to identify gaps where future work is needed by synthesizing the state-of-the-science across these clinical variabilities. In this scoping review, we summarize the available literature across different TBI severities and time from injury before providing a brief summary of basic science evidence on the topic and opportunities for future research.