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The effect of obesity on 12-month survival following admission to intensive care: a prospective study.
Crit Care Med. 2006 Dec; 34(12):2929-39.CC

Abstract

OBJECTIVE

Evaluate the effect of intensive care (ICU) admission body mass index (BMI) on 30-day and 12-month survival in critically ill patients and determine the impact of obesity on outcome.

DESIGN

Prospective, observational cohort study.

SETTING

Fourteen-bed medical and surgical ICU of a university-affiliated hospital.

PATIENTS

Four hundred and ninety-three adult patients.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

BMI (kg/m) was calculated from height (m) and measured weight (kg) within 4 hrs of ICU admission, using the PROMED weighing device, or premorbid weight (documented in the previous month) (BMImeasured). Follow-up was for >/=12 months post-ICU admission. Time to mortality outcome, censored at 30 and 365 days (12-months), was analyzed using a log-normal accelerated failure time regression model. Predictor variables were parameterized as time ratios (TR), where TR <1 is associated with decreased survival time and TR >1 is associated with prolonged survival time. Mean (sd) age and Acute Physiology and Chronic Health Evaluation II score were 62.3 (17.5) years and 20.7(8.4), respectively; 56.0% (285 of 493) of patients were male and 60.6% (299 of 493) medical. ICU admission weight and BMImeasured (available in 433 patients) were 79.1 (22.1) kg and 27.8 (7.0) kg/m, respectively. In 16.9% (73 of 433) of patients, weight was >/=100 kg, and in 29.8% (129 of 433), BMImeasured was >/=30 kg/m. Raw intensive care, 30-day, and 12-month mortality rates were 15.2% (66 of 433), 22.3% (95 of 433), and 37.3% (159 of 433), respectively. BMImeasured was a significant determinant of mortality at 30 days (TR 1.853, 95% confidence interval 1.053-3.260, p = .032) and 12 months (TR 1.034, 95% confidence interval 1.005-1.063, p = .019). The effect of BMI on 12-month mortality was linear, such that increasing BMI was associated with decreasing mortality.

CONCLUSIONS

ICU admission BMI was a determinant of short- to medium-term survival. Obesity was not associated with adverse outcomes and may be protective.

Authors+Show Affiliations

Department of Intensive Care Medicine, The Queen Elizabeth Hospital, Woodville, South Australia, Australia. sandra.peake@nwahs.sa.gov.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17075374

Citation

Peake, Sandra L., et al. "The Effect of Obesity On 12-month Survival Following Admission to Intensive Care: a Prospective Study." Critical Care Medicine, vol. 34, no. 12, 2006, pp. 2929-39.
Peake SL, Moran JL, Ghelani DR, et al. The effect of obesity on 12-month survival following admission to intensive care: a prospective study. Crit Care Med. 2006;34(12):2929-39.
Peake, S. L., Moran, J. L., Ghelani, D. R., Lloyd, A. J., & Walker, M. J. (2006). The effect of obesity on 12-month survival following admission to intensive care: a prospective study. Critical Care Medicine, 34(12), 2929-39.
Peake SL, et al. The Effect of Obesity On 12-month Survival Following Admission to Intensive Care: a Prospective Study. Crit Care Med. 2006;34(12):2929-39. PubMed PMID: 17075374.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of obesity on 12-month survival following admission to intensive care: a prospective study. AU - Peake,Sandra L, AU - Moran,John L, AU - Ghelani,Dhaval R, AU - Lloyd,Amanda J, AU - Walker,Michaela J, PY - 2006/11/1/pubmed PY - 2006/12/27/medline PY - 2006/11/1/entrez SP - 2929 EP - 39 JF - Critical care medicine JO - Crit Care Med VL - 34 IS - 12 N2 - OBJECTIVE: Evaluate the effect of intensive care (ICU) admission body mass index (BMI) on 30-day and 12-month survival in critically ill patients and determine the impact of obesity on outcome. DESIGN: Prospective, observational cohort study. SETTING: Fourteen-bed medical and surgical ICU of a university-affiliated hospital. PATIENTS: Four hundred and ninety-three adult patients. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: BMI (kg/m) was calculated from height (m) and measured weight (kg) within 4 hrs of ICU admission, using the PROMED weighing device, or premorbid weight (documented in the previous month) (BMImeasured). Follow-up was for >/=12 months post-ICU admission. Time to mortality outcome, censored at 30 and 365 days (12-months), was analyzed using a log-normal accelerated failure time regression model. Predictor variables were parameterized as time ratios (TR), where TR <1 is associated with decreased survival time and TR >1 is associated with prolonged survival time. Mean (sd) age and Acute Physiology and Chronic Health Evaluation II score were 62.3 (17.5) years and 20.7(8.4), respectively; 56.0% (285 of 493) of patients were male and 60.6% (299 of 493) medical. ICU admission weight and BMImeasured (available in 433 patients) were 79.1 (22.1) kg and 27.8 (7.0) kg/m, respectively. In 16.9% (73 of 433) of patients, weight was >/=100 kg, and in 29.8% (129 of 433), BMImeasured was >/=30 kg/m. Raw intensive care, 30-day, and 12-month mortality rates were 15.2% (66 of 433), 22.3% (95 of 433), and 37.3% (159 of 433), respectively. BMImeasured was a significant determinant of mortality at 30 days (TR 1.853, 95% confidence interval 1.053-3.260, p = .032) and 12 months (TR 1.034, 95% confidence interval 1.005-1.063, p = .019). The effect of BMI on 12-month mortality was linear, such that increasing BMI was associated with decreasing mortality. CONCLUSIONS: ICU admission BMI was a determinant of short- to medium-term survival. Obesity was not associated with adverse outcomes and may be protective. SN - 0090-3493 UR - https://www.unboundmedicine.com/medline/citation/17075374/The_effect_of_obesity_on_12_month_survival_following_admission_to_intensive_care:_a_prospective_study_ L2 - https://dx.doi.org/10.1097/01.CCM.0000248726.75699.B1 DB - PRIME DP - Unbound Medicine ER -