Extreme Obesity And Outcomes In Critically Ill Patients

Martino, Jenny L.; Stapleton, Renee D.; Cahill, Naomi E.; Suratt, Benjamin T.; Heyland, Daren K.

doi:10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a1646

Cited by 39 publications

(49 citation statements)

References 18 publications

(25 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our population, we found higher prevalence of obesity and morbid obesity and lower prevalence of underweight patients when compared with other reports [11,21,28 and 29]. In agreement with the findings of Martino et al, [29], we found an association between BMI categories and the increased requirement for MV and prolonged ICU stay. Our finding that overweight/obese and severely obese patients were more often to be female when compared with underweight and normal weight patients has been rarely reported for ICU populations [28].…”

Section: Discussionsupporting

confidence: 92%

Body mass index have no effect in hospital mortality or intensive care outcomes in an inner city population

Venkatram¹,

Rapaka²,

Anwer³

et al. 2013

Intern Med Inside

View full text Add to dashboard Cite

Background: The relationship between body mass index and outcome in the intensive care unit is controversial. The objective was to evaluate the incidence and effect of different body mass indexes on mortality, duration of mechanical ventilation, intensive care unit and hospital length of stay among critically ill medical patients. Methods: Retrospective, single center study in a medical intensive care unit of an inner city teaching hospital. All patients with available BMI levels on admission were included. Results: There were 1,988 patients admitted to the intensive care unit between January to December 2008; 1,797 (90.3%) were analyzed. Based in body mass index, 162 (9%) patients were underweight, 598 (33%) normal, 774 (43%) overweight/ obese and 263 (14.6%) severe obesity. Patients with obesity/severe obesity were more likely to be female (p<0.0001); to have hypertension (p=<0.0001), diabetes mellitus (p=<0.0001) and obstructive sleep apnea (p=<0.0001) as comorbid conditions. Severely obese patients had lower APACHE IV scores (66 ± 33 vs. 71 ± 32, p=0.035) and higher like hood of mechanical ventilation (105 (40%) vs. 180 (28%), p=<0.0007) when compared to normal. Underweight patients were sicker (APACHE IV 80 ± 32 vs. 71 ± 32, p=0.002) and more likely to have HIV infection (55 (36.6%) vs. 164 (26%), p=0.008) and cancer (22 vs. 51, p=0.017) compared to normal. Neither underweight, obesity nor severe obesity were associated with an increased risk of hospital mortality, (odd ratio=1.162; 95% confidence interval, 0.57-2.34 for underweight, odd ratio=1.04; 95% confidence interval, 0.62-1.75 for overweight/obese, odd ratio=1.23; 95% confidence interval, 0.64-2.39 for severe obesity). There were no differences in hospital length of stay or days on mechanical ventilation between the different body mass index groups. However, intensive care unit length of stay were significantly longer in the severe obese group by 1.2 days (95% confidence interval, 1.00-1.09; p=0.0015) compared with all the other groups. Conclusion: Body mass index in critically ill inner city patients is not associated with increased mortality. Severely obese patients have a longer intensive care unit length of stay, but not hospital stay. In our inner city MICU population, the prevalence of obesity and severe obesity is higher than reported.

show abstract

Section: Discussionsupporting

confidence: 92%

Body mass index have no effect in hospital mortality or intensive care outcomes in an inner city population

Venkatram¹,

Rapaka²,

Anwer³

et al. 2013

Intern Med Inside

View full text Add to dashboard Cite

show abstract

“…Interestingly, obesity has been identified as a risk factor for death from influenza A-associated ARDS, 6,7 although these studies were small. Larger adult critical care studies have shown that although obesity may be associated with longer ICU stay, when controlling for severity of illness, the mortality is the same 8,9 or lower 10 than for nonobese adults. In non-ICU settings, a 2013 metaanalysis 11 of 2.88 million adult patients found that the overweight group had a statistically significant lower all-cause mortality.…”

mentioning

confidence: 99%

Obesity and Mortality Risk in Critically Ill Children

et al. 2016

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVES:Childhood obesity is epidemic and may be associated with PICU mortality. Using a large multicenter PICU database, we investigated the association between obesity and PICU mortality, adjusting for initial severity of illness. We further investigated whether height-and weight-based classifications of obesity compared with a weight-based classification alone alter the mortality distribution.

show abstract

“…25 Chronic obesity results in pathophysiological alterations in all major organ systems; the main derangements are in cardiovascular, respiratory, and metabolic functions. 26 Many recent studies [27][28][29][30][31][32][33][34][35][36] on morbidity and mortality rates of obese critically ill patients have indicated that although obesity may not have an effect on hospital mortality rates (and may even have a protective effect), obese patients tend to have increased hospital morbidity as evidenced by longer duration of mechanical ventilation, longer ICU length of stay, longer hospital length of stay, and increased rate of infection. Missed or delayed detection of malnutrition in these patients may contribute to these adverse outcomes.…”

Section: Risk For Malnutrition In Obese Critically Ill Patientsmentioning

confidence: 99%

New Guidelines for Assessment of Malnutrition in Adults: Obese Critically Ill Patients

Mauldin

O’Leary-Kelley

2015

Critical Care Nurse

View full text Add to dashboard Cite

Recently released recommendations for detection and documentation of malnutrition in adults in clinical practice define 3 types of malnutrition: starvation related, acute disease or injury related, and chronic disease related. The first 2 are more easily recognized, but the third may be more often unnoticed, particularly in obese patients. Critical care patients tend to be at high risk for malnutrition and thus require a thorough nutritional assessment. Compared with patients of earlier times, intensive care unit patients today tend to be older, have more complex medical and comorbid conditions, and often are obese. Missed or delayed detection of malnutrition in these patients may contribute to increases in hospital morbidity and longer hospital stays. Critical care nurses are in a prime position to screen patients at risk for malnutrition and to work with members of the interprofessional team in implementing nutritional intervention plans.

show abstract

Extreme Obesity And Outcomes In Critically Ill Patients

Cited by 39 publications

References 18 publications

Body mass index have no effect in hospital mortality or intensive care outcomes in an inner city population

Body mass index have no effect in hospital mortality or intensive care outcomes in an inner city population

Obesity and Mortality Risk in Critically Ill Children

New Guidelines for Assessment of Malnutrition in Adults: Obese Critically Ill Patients

Contact Info

Product

Resources

About