Morbid obesity in the medical ICU.

@article{ElSolh2001MorbidOI,
  title={Morbid obesity in the medical ICU.},
  author={Ali A. El‐Solh and Pawan Sikka and Erkan Bozkanat and Wafaa Jaafar and Jane Davies},
  journal={Chest},
  year={2001},
  volume={120 6},
  pages={
          1989-97
        }
}
STUDY OBJECTIVE To describe the clinical course, complications, and prognostic factors of morbidly obese patients admitted to the ICU compared to a control group of nonobese patients. DESIGN A retrospective study. SETTING Two university-affiliated hospitals. METHODS We reviewed the medical records of 117 morbidly obese patients (body mass index >/= 40 kg/m(2)) admitted to the medical ICU between January 1994 and June 2000. Data collected included demographic information, comorbid… 

Figures and Tables from this paper

Outcome of Morbid Obesity in the Intensive Care Unit
TLDR
Morbidly obese patients (body mass index >40 kg/m2) admitted to intensive care units have higher rates of mortality, nursing home admission, and intensive care unit complications and have longer stays in theintensive care unit and time on mechanical ventilation.
The Effect of Obesity on Outcomes in Mechanically Ventilated Patients in a Medical Intensive Care Unit
TLDR
Obesity did not influence outcomes in critically ill patients requiring invasive mechanical ventilation in a medical ICU and multivariate analysis using logistic regression showed no significant relationship between mortality rate at 30 days following intubation and obesity.
Impact of obesity in mechanically ventilated patients: a prospective study
TLDR
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.
Association of Obesity with Increased Mortality in the Critically Ill Patient
TLDR
Mortality of obese critically ill patients was not higher than patients with normal weight, and the hospital mortality was lower for patients with BMI >40 kg/m2 compared to the normal BMI group despite similar severity of illness, suggesting obesity might have a protective effect.
Medical Versus Surgical ICU Obese Patient Outcome: A Propensity-Matched Analysis to Resolve Clinical Trial Controversies
TLDR
It is suggested that ICU mortality in obese population was higher in the medical group than in the surgical group and remains significantly higher 365 days post ICU admission.
Influence of Overweight on ICU Mortality *
TLDR
This is the first prospective study showing high BMI value as an independent prognostic factor of mortality for ICU patients, and the prognostic scoring systems currently in use, which do not include BMI or do not consider obesity may underestimate the risk.
Outcomes of morbidly obese patients requiring mechanical ventilation for acute respiratory failure*
TLDR
The type of ventilatory assistance may influence clinical outcomes in morbidly obese patients with acute respiratory failure and hospital mortality for the invasive ventilation and NIV failure groups was increased.
Influence of overweight on ICU mortality: a prospective study.
TLDR
This is the first prospective study showing high BMI value as an independent prognostic factor of mortality for ICU patients, and may underestimate the risk for the specific population of obese patients.
Intensive Care Unit Outcomes Are Not Adversely Affected by Obesity in Patients with Respiratory Failure
TLDR
Obese patients in the ICU requiring mechanical ventilation for respiratory failure have similar mortality, LOS, and cost outcomes as normal weight patients, and have similar levels of disability independent of BM.
...
...

References

SHOWING 1-10 OF 39 REFERENCES
A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study.
TLDR
The SAPS II, based on a large international sample of patients, provides an estimate of the risk of death without having to specify a primary diagnosis and is a starting point for future evaluation of the efficiency of intensive care units.
Postoperative Hypoxemia in Obese Patients
TLDR
It is suggested that careful monitoring of arterial blood gases in obese patients and the administration of oxygen and appropriate electrolyte solutions postoperatively to reduce the increased morbidity and mortality is suggested.
Obesity and increased mortality in blunt trauma.
To determine the effect of admission body weight on blunt trauma victims, a chart review of all patients greater than 12 years of age admitted to Sentara Norfolk General Hospital between January 1
Increased early morbidity and mortality with acceptable long‐term function in severely obese patients undergoing liver transplantation
TLDR
Liver transplantation in severely obese patients is associated with wound infection and early death from multisystem organ failure, but has similar long‐term outcomes when compared to non‐obese controls.
The obese patient in the ICU.
TLDR
The purpose of this article is to review some of the basic concepts related to the treatment of obese patients in the ICU.
Identification of patients with acute lung injury. Predictors of mortality.
TLDR
If selection of patients using the new criteria for acute lung injury results in a significant change in the clinical characteristics, risk factors, or predictors of mortality when compared with prior studies of patients with adult respiratory distress syndrome, and to determine if a quantitative index of the severity of lung injury has prognostic value in identifying nonsurvivors of acute Lung injury.
The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults.
TLDR
The overall predictive accuracy of the first-day APACHE III equation was such that, within 24 h ofICU admission, 95 percent of ICU admissions could be given a risk estimate for hospital death that was within 3 percent of that actually observed.
Evaluation of acute physiology and chronic health evaluation III predictions of hospital mortality in an independent database.
TLDR
APACHE III accurately predicted aggregate hospital mortality in an independent sample of U.S. ICU admissions and further improvements in calibration can be achieved by more precise disease labeling, improved acquisition and weighting of neurologic abnormalities, adjustments that reflect changes in treatment outcomes over time, and a larger national database.
Mortality Probability Models (MPM II) based on an international cohort of intensive care unit patients.
TLDR
Among severity systems for intensive care patients, the MPM0 is the only model available for use at ICU admission and bothMPM0 and MPM24 are useful research tools and provide important clinical information when used alone or together.
Validation of the simplified therapeutic intervention scoring system on an independent database
TLDR
TISS-28 can replace TISS-76 for the measurement of the nursing workload in Portuguese ICUs, and was validated on this independent population.
...
...