Effect of obesity on intensive care morbidity and mortality: a meta-analysis. Crit Care Med

Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Western New York Respiratory Research Center, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA.
Critical care medicine (Impact Factor: 6.31). 01/2008; 36(1):151-8. DOI: 10.1097/01.CCM.0000297885.60037.6E
Source: PubMed


To evaluate the effect of obesity on intensive care unit mortality, duration of mechanical ventilation, and intensive care unit length of stay among critically ill medical and surgical patients.
Meta-analysis of studies comparing outcomes in obese (body mass index of > or = 30 kg/m2) and nonobese (body mass index of < 30 kg/m2) critically ill patients in intensive care settings.
MEDLINE, BIOSIS Previews, PubMed, Cochrane library, citation review of relevant primary and review articles, and contact with expert informants.
Not applicable.
A total of 62,045 critically ill subjects.
Descriptive and outcome data regarding intensive care unit mortality and morbidity were extracted by two independent reviewers, according to predetermined criteria. Data were analyzed using a random-effects model.
Fourteen studies met inclusion criteria, with 15,347 obese patients representing 25% of the pooled study population. Data analysis revealed that obesity was not associated with an increased risk of intensive care unit mortality (relative risk, 1.00; 95% confidence interval, 0.86-1.16; p = .97). However, duration of mechanical ventilation and intensive care unit length of stay were significantly longer in the obese group by 1.48 days (95% confidence interval, 0.07-2.89; p = .04) and 1.08 days (95% confidence interval, 0.27-1.88; p = .009), respectively, compared with the nonobese group. In a subgroup analysis, an improved survival was observed in obese patients with body mass index ranging between 30 and 39.9 kg/m2 compared with nonobese patients (relative risk, 0.86; 95% confidence interval, 0.81-0.91; p < .001).
Obesity in critically ill patients is not associated with excess mortality but is significantly related to prolonged duration of mechanical ventilation and intensive care unit length of stay. Future studies should target this population for intervention studies to reduce their greater resource utilization.

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Available from: Ali El Solh, Jul 26, 2014
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    Injury 11/2014; 45(11):1798–1799. DOI:10.1016/j.injury.2013.09.033 · 2.14 Impact Factor
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    • ". The current strategy is to implement an individualized approach taking into consideration the patient underlying comorbidities, reason for mechanical ventilation (MV), and potential complications of the procedure. One particular group that has consistently been associated with prolonged MV and ICU length of stay (LOS) is the morbidly obese patients [11] [12]. With a large and increasing population of obese mechanically ventilated patients, placement of tracheostomy represents a challenge because of the potentially higher complication rate with either surgical or percutaneous dilatory tracheotomy [13]. "
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    Critical care research and practice 09/2014; 2014:840638. DOI:10.1155/2014/840638
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    • "However, published data on outcome in overweight children and adults is conflicting [11–14]. Broadly, adult intensive care unit (AICU) data suggest increased duration of mechanical ventilation and ICU stay but no clear association with mortality [15–17]. "
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    Intensive Care Medicine 07/2014; 40(8). DOI:10.1007/s00134-014-3381-x · 7.21 Impact Factor
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