To study the relationship between BMI, complications and outcome in patients admitted to surgical intensive care unit (SICU).
Review of prospective acquired SICU data on patients with BMI under 18.5 (UBMI) and normal BMI between 18.5 and 24.9 (NBMI). All patients were followed until death or discharged from the hospital. Data collected: weight, height, age, gender, indication for admission in the SICU, co-morbid conditions, length of mechanical ventilation, LOS, APACHE II, III and Simplified Acute Physiology Scores (SAPS), ARDS, A-fib, MI, Septicemia, VAP and mortality. Univariate inspection of the relationship between normal and UBMI grouping and continuous variables was explored with the Mann-Whitney test (a nonparametric counterpart to the t-test), and categorical variables with the Chi-square or Fisher's Exact test. “Time until” was explored with standard methods of survival methodology, p > .01.
Seven hundred and ninety-three patients were evaluated, 706 with NBMI (mean 22.12) and 87 in UBMI (mean 16.81) group. There was no statistically significant difference in APACHE II–III, and SAPS scores. There were 74 complications in the UBMI, in NBMI more infectious and in UBMI more pulmonary complications occurred (Chi-square, P < 0.0087). There was no significant difference in ARDS, A fib, MI, Septicemia, VAP (Fisher's Exact test, P = 0.38; chi square, P = 0.41). Overall there was 14.4% (114/793) hospital mortality; 99 patients expired in the NBMI, and 15 patients in UBMI (Fisher exact test P = 0.01). The ICU length of stay between the two groups was not significant (6.66 vs. 5.80 days; p = 0.64). Overall there was 11.1% (88/793) SICU mortality; 74/706 patients expired in NBMI, and 14/87 patients in UBMI.
UBMI is associated with increased mortality in SICU patients. A body mass index less than 18.5 is an independent factor affecting outcome in surgical critical care patients.
BMI should be evaluated at admission to ICU as it independently affects the complications and outcome.
Rajeev Gupta, No Financial Disclosure Information; No Product/Research Disclosure Information