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Body Mass Index and Intensive Care Unit Outcomes FREE TO VIEW

Alicia Thomas, MD; Laura Kharsa, MD; O'Dene Lewis, MD; Ho Anh, MD; Rachel Jeanty, MD; Simon Mates, MD; Rosanna Setse, MD; Alem Mehari, MD
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Howard University Hospital, Washington, DC

Chest. 2013;144(4_MeetingAbstracts):564A. doi:10.1378/chest.1704990
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SESSION TITLE: Outcomes/Quality Control Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: To determine the effect of obesity on outcomes of patients admitted to the medical ICU (Intensive Care Unit).

METHODS: A retrospective chart review of 107 African American patients aged 18 years and older admitted to the medical ICU for greater than 24 hours between January to June 2012 was performed. Body mass index (BMI in Kg/m2) groups were categorized as < 30, 30-40 and > 40. Our primary outcome was ICU mortality and secondary outcomes included hospital length of stay (LOS) and need for mechanical ventilation (MV). Analysis was done using STATA software.

RESULTS: Mean BMI was 31.1 (±11.1). Fifty-two (48.6%), 30 (28.0%) and 25 (23.4%) of 107 patients had BMI’s of <30, 30-40 and >40 respectfully. ICU death rate was 50.1% in BMI group <30, 24% in BMI 30-40 and 28.7% in BMI >40 ( p<0.001). MV occurred in 58 patients (54.2%) with 35 (60%) in BMI group <30, 13 (22.4%) with BMI 30-40, and 10 (17.2%) with BMI > 40 (p=0.03). In the multivariable analysis, the adjusted odds ratio (AOR) of ICU mortality in the extremely obese group (BMI>40) and those with BMI of 30-40 versus those with BMI of <30 were 4.3, p= 0.07 and 0.2 p= 0.10 respectfully. MV was associated with a 13 fold increased risk for ICU mortality [AOR 13.9, p= 0.001]. Every year increase in age was associated with a 10% greater likelihood of ICU mortality (p=0.01). There was a nonsignificant increased ICU LOS in patients with BMI >40 compared with those having a BMI <30 (p =0.05) but no significant difference in hospital LOS days across BMI groups.

CONCLUSIONS: Our multivariate analysis showed, older age, and MV were associated with increased risk for ICU mortality. There was a tendency for an increased mortality risk among the extremely obese patients with BMI > 40.

CLINICAL IMPLICATIONS: Obese patients represent approximately 25% of ICU admissions, the prevalence of which is increasing in the African American Population. Our findings indicate the need for increased awareness, research and implementation of strategies to improve outcomes in critically ill extremely obese patients.

DISCLOSURE: The following authors have nothing to disclose: Alicia Thomas, Laura Kharsa, O'Dene Lewis, Ho Anh, Rachel Jeanty, Simon Mates, Rosanna Setse, Alem Mehari

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