PURPOSE: To evaluate the impact of obesity on ICU mortality, duration of mechanical ventilation, and ICU length of stay among critically ill medical and surgical patients.
METHODS: Descriptive and outcome data regarding ICU mortality and morbidity were extracted by two independent reviewers, according to predetermined criteria. Data were analyzed using a random effects model.
RESULTS: 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 ICU mortality (relative risk (RR) 1.00, 95% confidence interval (CI) 0.86-1.16; p = 0.97). However, duration of mechanical ventilation and ICU length of stay were significantly longer in the obese group by 1.48 days (95% CI, 0.07-2.89; p=0.04) and 1.08 days (95% CI, 0.27-1.88; p=0.009), respectively, compared to the nonobese group. In a subgroup analysis, an improved survival was observed in obese patients with BMI ranging between 30 and 39.9 kg/m2 compared to nonobese (RR 0.86, 95% CI 0.81-0.91; p<0.001).
CONCLUSION: Obesity in critically ill patients is not associated with excess mortality but is significantly related to prolonged duration of mechanical ventilation and ICU length of stay. Future studies should target this population for intervention studies to reduce their greater resource utilization.
CLINICAL IMPLICATIONS: While mild and moderate obesity may be protective during critical illness, morbid obesity does not have an adverse effect on outcome. However obese patients do have increased morbidity as measured by duration of mechanical ventilation and LOS. Longer LOS might have significant implications for health care costs.
DISCLOSURE: Morohunfolu Akinnusi, No Financial Disclosure Information; No Product/Research Disclosure Information