Fernanda Souza Angotti Carrara1, Suely Sueko Viski Zanei2, Mariana Fernandes Cremasco3, Iveth Yamaguchi Whitaker4. 1. São Paulo Hospital - University Hospital at Federal University of São Paulo - UNIFESP, Rua Doutor Diogo de Faria, 816, 04037-002 São Paulo, Brazil. Electronic address: fercarrara@hotmail.com. 2. Paulista Nursing School, Federal University of São Paulo, UNIFESP, Rua Napoleão de Barros, 754, Vila Clementino, 04024-002 São Paulo, SP, Brazil. Electronic address: suelyzanei@unifesp.br. 3. Intensive Care Nursing, Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address: maricremasco@yahoo.com.br. 4. Paulista Nursing School, Federal University of São Paulo, UNIFESP, Rua Napoleão de Barros, 754, Vila Clementino, 04024-002 São Paulo, SP, Brazil. Electronic address: iveth.whitaker@unifesp.br.
Abstract
OBJECTIVES: To compare the morbidity and mortality of patients with a body mass index (BMI) < and ≥30kg/m(2) and to identify risk factors related to death and length of stay of obese patients in the intensive care unit (ICU). METHODS: Prospective and cross-sectional study. SETTING: A 35-bed mixed ICU in São Paulo, Brazil. RESULTS: The sample consisted of 530 patients, of which 105 (19.8%) had a BMI ≥30kg/m(2). A significantly higher number of obese patients were female (p=0.025). The mortality, morbidity and nursing workload were not different between the obese and nonobese groups. However, the morbidly obese patients were younger (p<0.001), had a lower Charlson Comorbidity Index (CI; p=0.002), lower Simplified Acute Physiology Score 3 (SAPS 3; p=0.047), lower Sepsis-related Organ Failure Assessment (SOFA) score (p=0.019), shorter ICU length of stay (LOS; p=0.015) and hospital LOS (p=0.039), and an increased mean nursing workload (Nursing Activities Score (NAS; p=0.004)). The SOFA score and nursing workload were identified as risk factors associated with death in the ICU. These two variables, in addition to the admission category and duration of mechanical ventilation (MV), were also related to the ICU LOS, which demonstrates an inverse relationship between the NAS and LOS. CONCLUSION: Although the morbidity, mortality and nursing workload were not significantly different between the obese and nonobese groups, our results contribute additional information to the relationship between obesity and clinical discharge and inform future research.
OBJECTIVES: To compare the morbidity and mortality of patients with a body mass index (BMI) < and ≥30kg/m(2) and to identify risk factors related to death and length of stay of obesepatients in the intensive care unit (ICU). METHODS: Prospective and cross-sectional study. SETTING: A 35-bed mixed ICU in São Paulo, Brazil. RESULTS: The sample consisted of 530 patients, of which 105 (19.8%) had a BMI ≥30kg/m(2). A significantly higher number of obesepatients were female (p=0.025). The mortality, morbidity and nursing workload were not different between the obese and nonobese groups. However, the morbidly obesepatients were younger (p<0.001), had a lower Charlson Comorbidity Index (CI; p=0.002), lower Simplified Acute Physiology Score 3 (SAPS 3; p=0.047), lower Sepsis-related Organ Failure Assessment (SOFA) score (p=0.019), shorter ICU length of stay (LOS; p=0.015) and hospital LOS (p=0.039), and an increased mean nursing workload (Nursing Activities Score (NAS; p=0.004)). The SOFA score and nursing workload were identified as risk factors associated with death in the ICU. These two variables, in addition to the admission category and duration of mechanical ventilation (MV), were also related to the ICU LOS, which demonstrates an inverse relationship between the NAS and LOS. CONCLUSION: Although the morbidity, mortality and nursing workload were not significantly different between the obese and nonobese groups, our results contribute additional information to the relationship between obesity and clinical discharge and inform future research.