OBJECTIVE: To analyze the influence of severe obesity on mortality and morbidity in mechanically ventilated intensive care unit (ICU) patients. DESIGN: Prospective, multi-center exposed/unexposed matched epidemiologic study. SETTING: Hospital setting. PATIENTS: Severely obese patients (body mass index (BMI) >or= 35 kg/m(2)), mechanically ventilated for at least 2 days were matched with unexposed nonobese patients (BMI < 30 kg/m(2)) for center, gender, age (+/-5 years), and the simplified acute physiology (SAPS) II score (+/-5 points). We recorded tracheal intubation, catheter placement, nosocomial infections, development of pressure ulcers, ICU and hospital outcome. RESULTS: Eighty-two severely obese patients (mean BMI, 42 +/- 6 kg/m(2)) were compared to 124 nonobese patients (mean BMI, 24 +/- 4 kg/m(2)). The ICU course was similar in both the groups, except for the difficulties during tracheal intubation (15 vs. 6%) and post-extubation stridor (15% vs. 3%), which were significantly more frequent in obese patients (P < 0.05). The ICU mortality rate did not differ between obese and nonobese patients (24 and 25%, respectively); nor did the risk-adjusted hospital mortality rate (0.76, 95% confidence interval 0.41-1.16 in obese patients versus 0.82, 95% confidence interval 0.54-1.13 in nonobese patients). Conditional logistic regression confirmed that mortality was not associated with obesity. CONCLUSION: The only difference in morbidity of obese patients who were mechanically ventilated was increased difficulty with tracheal intubation and a higher frequency of post-extubation stridor. Obesity was not associated either with increased ICU mortality or with hospital mortality.
OBJECTIVE: To analyze the influence of severe obesity on mortality and morbidity in mechanically ventilated intensive care unit (ICU) patients. DESIGN: Prospective, multi-center exposed/unexposed matched epidemiologic study. SETTING: Hospital setting. PATIENTS: Severely obesepatients (body mass index (BMI) >or= 35 kg/m(2)), mechanically ventilated for at least 2 days were matched with unexposed nonobese patients (BMI < 30 kg/m(2)) for center, gender, age (+/-5 years), and the simplified acute physiology (SAPS) II score (+/-5 points). We recorded tracheal intubation, catheter placement, nosocomial infections, development of pressure ulcers, ICU and hospital outcome. RESULTS: Eighty-two severely obesepatients (mean BMI, 42 +/- 6 kg/m(2)) were compared to 124 nonobese patients (mean BMI, 24 +/- 4 kg/m(2)). The ICU course was similar in both the groups, except for the difficulties during tracheal intubation (15 vs. 6%) and post-extubation stridor (15% vs. 3%), which were significantly more frequent in obesepatients (P < 0.05). The ICU mortality rate did not differ between obese and nonobese patients (24 and 25%, respectively); nor did the risk-adjusted hospital mortality rate (0.76, 95% confidence interval 0.41-1.16 in obesepatients versus 0.82, 95% confidence interval 0.54-1.13 in nonobese patients). Conditional logistic regression confirmed that mortality was not associated with obesity. CONCLUSION: The only difference in morbidity of obesepatients who were mechanically ventilated was increased difficulty with tracheal intubation and a higher frequency of post-extubation stridor. Obesity was not associated either with increased ICU mortality or with hospital mortality.
Authors: James M O'Brien; Carolyn H Welsh; Ronald H Fish; Marek Ancukiewicz; Andrew M Kramer Journal: Ann Intern Med Date: 2004-03-02 Impact factor: 25.391
Authors: Sogol Nowbar; Kristin M Burkart; Ralph Gonzales; Andrew Fedorowicz; Wendolyn S Gozansky; Jon C Gaudio; Matthew R G Taylor; Clifford W Zwillich Journal: Am J Med Date: 2004-01-01 Impact factor: 4.965
Authors: James M O'Brien; Gary S Phillips; Naeem A Ali; Maria Lucarelli; Clay B Marsh; Stanley Lemeshow Journal: Crit Care Med Date: 2006-03 Impact factor: 7.598
Authors: Bettina Wurzinger; Martin W Dünser; Christoph Wohlmuth; Martina C Deutinger; Hanno Ulmer; Christian Torgersen; Christian A Schmittinger; Wilhelm Grander; Walter R Hasibeder Journal: Wien Klin Wochenschr Date: 2010-01 Impact factor: 1.704
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