{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T02:48:41Z","timestamp":1776048521228,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T00:00:00Z","timestamp":1768089600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T00:00:00Z","timestamp":1768089600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR004419"],"award-info":[{"award-number":["UL1TR004419"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity Reviews"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The relationship between obesity and traumatic brain injury is complex and not fully understood. While obesity is commonly linked to worse outcomes, conflicting data support the \u201cobesity paradox,\u201d with higher body mass index showing protective effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified patients with traumatic brain injury and defined two propensity score\u2013matched cohorts: patients with normal weight and patients with obesity. Outcomes were compared using risk estimates, odds ratios, Kaplan\u2013Meier survival analysis, and log\u2010rank testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Obesity was associated with slightly lower risks of the following:<\/jats:p>\n                    <jats:p>\n                      <jats:bold>\u2022 Pneumonia<\/jats:bold>\n                      (5.1% vs. 3.4%, OR 1.53 [95% CI: 1.015\u20132.297],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041),\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\u2022 Acute kidney injury<\/jats:bold>\n                      (9.3% vs. 6.8%, OR 1.41 [95% CI: 1.047\u20131.908],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023),\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\u2022 Myocardial infarction<\/jats:bold>\n                      (3.4% vs. 1.7%, OR 2.04 [95% CI: 1.182\u20133.503],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009),\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\u2022 Cognitive deficits<\/jats:bold>\n                      (16.9% vs. 11.9%, OR 1.52 [95% CI: 1.201\u20131.914],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001),\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\u2022 Cardiac arrest<\/jats:bold>\n                      (2.5% vs. 0.8%, OR 3.05 [95% CI: 1.485\u20136.272],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001),\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\u2022 Emergency department visits or admissions<\/jats:bold>\n                      (16.1% vs. 12.7%, OR 1.32 [95% CI: 1.046\u20131.661],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019),\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\u2022 Emergency procedures<\/jats:bold>\n                      (16.1% vs. 11.9%, OR 1.43 [95% CI: 1.127\u20131.803],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003),\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\u2022 Twist drill\/burr hole procedures<\/jats:bold>\n                      (1.7% vs. 0.8%, HR 2.67 [95% CI: 1.045\u20136.827],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.033 by log\u2010rank test),\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\u2022 Mortality<\/jats:bold>\n                      was not significantly different.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with obesity exhibited a lower incidence of selected complications, supporting the obesity paradox in neurotrauma. However, that did not translate into differences in mortality or functional outcomes. Body mass index may not fully capture the complexities of body composition or functional reserve, highlighting the need for studies using comprehensive adiposity and metabolic measures. Given multiple outcomes tested and modest effect sizes, these findings should be interpreted cautiously.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/obr.70069","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T04:55:32Z","timestamp":1768193732000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Body Mass Index as a Prognostic Factor in Traumatic Brain Injury: Insights from a Real\u2010World Cohort"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3084-0217","authenticated-orcid":false,"given":"Barbara","family":"Buccilli","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Icahn School of Medicine at Mount Sinai  New York City New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2017.99"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.027900"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.25259\/SNI_774_2023"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.25259\/SNI_776_2023"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.25259\/SNI_773_2023"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/2020.3.JNS193458"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12974\u2010024\u201003104\u20109"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s42255\u2010024\u201001079\u20108"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp\u20102023\u2010331562"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2018.05.523"},{"key":"e_1_2_10_12_1","first-page":"59","volume-title":"From Anatomy to Function of the Central Nervous System","author":"Ascenzi B. 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