BACKGROUND: The association between body mass index (BMI) and outcomes in critically ill patients is unclear. Our objective was to determine the association between BMI and outcomes in a population-based cohort of patients with acute lung injury (ALI). METHODS: In a prospective cohort study of all ICU patients in King County, Washington, with ALI in 1 year (1999 to 2000), 825 patients had a BMI recorded. Using multivariate analysis, patients in the abnormal BMI groups were compared to normal patients in the following areas: mortality, hospital length of stay (LOS), ICU LOS, duration of mechanical ventilation, and discharge disposition. RESULTS: There was no mortality difference in any of the abnormal BMI groups compared to normal-weight patients. Severely obese patients had longer hospital LOS than normal-weight patients (mean increase, 10.5 days; 95% confidence interval [CI], 4.8 to 16.2 days; p < 0.001); this was accentuated when analysis was restricted to survivors (mean increase, 14.3 days; 95% CI, 7.1 to 21.6 days; p < 0.001). ICU LOS and duration of mechanical ventilation were also longer in the severely obese group when analysis was restricted to survivors (mean increase, 5.6 days; 95% CI, 1.3 to 9.8 days; p = 0.01; and mean increase, 4.1 days; 95% CI, 0.4 to 7.7 days, respectively; p = 0.03). Severely obese patients were more likely to be discharged to a rehabilitation or skilled nursing facility than to home. CONCLUSIONS: BMI is not associated with mortality in patients with ALI, but severe obesity is associated with increased morbidity and resource utilization in the hospital and after discharge.
BACKGROUND: The association between body mass index (BMI) and outcomes in critically illpatients is unclear. Our objective was to determine the association between BMI and outcomes in a population-based cohort of patients with acute lung injury (ALI). METHODS: In a prospective cohort study of all ICU patients in King County, Washington, with ALI in 1 year (1999 to 2000), 825 patients had a BMI recorded. Using multivariate analysis, patients in the abnormal BMI groups were compared to normal patients in the following areas: mortality, hospital length of stay (LOS), ICU LOS, duration of mechanical ventilation, and discharge disposition. RESULTS: There was no mortality difference in any of the abnormal BMI groups compared to normal-weight patients. Severely obesepatients had longer hospital LOS than normal-weight patients (mean increase, 10.5 days; 95% confidence interval [CI], 4.8 to 16.2 days; p < 0.001); this was accentuated when analysis was restricted to survivors (mean increase, 14.3 days; 95% CI, 7.1 to 21.6 days; p < 0.001). ICU LOS and duration of mechanical ventilation were also longer in the severely obese group when analysis was restricted to survivors (mean increase, 5.6 days; 95% CI, 1.3 to 9.8 days; p = 0.01; and mean increase, 4.1 days; 95% CI, 0.4 to 7.7 days, respectively; p = 0.03). Severely obesepatients were more likely to be discharged to a rehabilitation or skilled nursing facility than to home. CONCLUSIONS: BMI is not associated with mortality in patients with ALI, but severe obesity is associated with increased morbidity and resource utilization in the hospital and after discharge.
Authors: Shan L Ward; Virginia Gildengorin; Stacey L Valentine; Anil Sapru; Martha A Q Curley; Neal Thomas; Douglas F Willson; Heidi R Flori Journal: Crit Care Med Date: 2016-11 Impact factor: 7.598
Authors: Jenny L Martino; Renee D Stapleton; Miao Wang; Andrew G Day; Naomi E Cahill; Anne E Dixon; Benjamin T Suratt; Daren K Heyland Journal: Chest Date: 2011-08-04 Impact factor: 9.410
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Authors: Yasser Sakr; Christian Madl; Daniela Filipescu; Rui Moreno; Johan Groeneveld; Antonio Artigas; Konrad Reinhart; Jean-Louis Vincent Journal: Intensive Care Med Date: 2008-08-01 Impact factor: 17.440