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The obesity paradox in surgical intensive care unit patients.
Intensive Care Med. 2011 Nov; 37(11):1793-9.IC

Abstract

PURPOSE

To investigate the possible impact of obesity, as assessed by body mass index (BMI), on outcome in surgical intensive care unit (ICU) patients.

METHODS

Prospectively collected data from all consecutive adult patients admitted to our ICU between January 2004 and January 2009 were analysed retrospectively. BMI was calculated using the formula: BMI = body weight/height(2) (kg/m(2)), and patients were grouped as underweight (<18.5 kg/m(2)), normal weight (18.5-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), obese (30-39.9 kg/m(2)) and very obese (≥40 kg/m(2)).

RESULTS

Among the 12,938 patients who were admitted to our ICU during the study period, 9,935 (76.8%) had complete height and weight data and constituted the study group. The mean BMI was 27.1 ± 5.0 kg/m(2). Overall, 34.4% of the study population had normal BMI, 1.8% were underweight, 41.2% were overweight, 20.8% were obese and 1.8% were very obese. The ICU mortality rate was similar among BMI subgroups, but hospital mortality was higher in underweight patients than in patients with normal BMI (17.8% versus 11.1%, P = 0.006). On multivariate Cox regression analysis, being overweight [hazard ratio (HR) 0.86, 95% confidence interval (CI) 0.74-0.99, P = 0.047] or obese (HR = 0.83, 95% CI = 0.69-0.99, P = 0.047) was independently associated with lower 60-day in-hospital mortality, with normal BMI as the reference category. Risk of death increased in very obese patients, especially after neurosurgical procedures (HR = 0.3, 95% CI = 1.06-8.48, P = 0.039).

CONCLUSION

In this cohort of surgical ICU patients, being overweight or obese was associated with decreased risk of 60-day in-hospital mortality.

Authors+Show Affiliations

Department of Anaesthesiology and Intensive Care, Friedrich-Schiller-University, Erlanger Allee 103, 07743, Jena, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21818652

Citation

Hutagalung, Robert, et al. "The Obesity Paradox in Surgical Intensive Care Unit Patients." Intensive Care Medicine, vol. 37, no. 11, 2011, pp. 1793-9.
Hutagalung R, Marques J, Kobylka K, et al. The obesity paradox in surgical intensive care unit patients. Intensive Care Med. 2011;37(11):1793-9.
Hutagalung, R., Marques, J., Kobylka, K., Zeidan, M., Kabisch, B., Brunkhorst, F., Reinhart, K., & Sakr, Y. (2011). The obesity paradox in surgical intensive care unit patients. Intensive Care Medicine, 37(11), 1793-9. https://doi.org/10.1007/s00134-011-2321-2
Hutagalung R, et al. The Obesity Paradox in Surgical Intensive Care Unit Patients. Intensive Care Med. 2011;37(11):1793-9. PubMed PMID: 21818652.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The obesity paradox in surgical intensive care unit patients. AU - Hutagalung,Robert, AU - Marques,Juliana, AU - Kobylka,Kathrin, AU - Zeidan,Mohamed, AU - Kabisch,Bjorn, AU - Brunkhorst,Frank, AU - Reinhart,Konrad, AU - Sakr,Yasser, Y1 - 2011/08/05/ PY - 2010/08/14/received PY - 2011/06/10/accepted PY - 2011/8/6/entrez PY - 2011/8/6/pubmed PY - 2012/3/1/medline SP - 1793 EP - 9 JF - Intensive care medicine JO - Intensive Care Med VL - 37 IS - 11 N2 - PURPOSE: To investigate the possible impact of obesity, as assessed by body mass index (BMI), on outcome in surgical intensive care unit (ICU) patients. METHODS: Prospectively collected data from all consecutive adult patients admitted to our ICU between January 2004 and January 2009 were analysed retrospectively. BMI was calculated using the formula: BMI = body weight/height(2) (kg/m(2)), and patients were grouped as underweight (<18.5 kg/m(2)), normal weight (18.5-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), obese (30-39.9 kg/m(2)) and very obese (≥40 kg/m(2)). RESULTS: Among the 12,938 patients who were admitted to our ICU during the study period, 9,935 (76.8%) had complete height and weight data and constituted the study group. The mean BMI was 27.1 ± 5.0 kg/m(2). Overall, 34.4% of the study population had normal BMI, 1.8% were underweight, 41.2% were overweight, 20.8% were obese and 1.8% were very obese. The ICU mortality rate was similar among BMI subgroups, but hospital mortality was higher in underweight patients than in patients with normal BMI (17.8% versus 11.1%, P = 0.006). On multivariate Cox regression analysis, being overweight [hazard ratio (HR) 0.86, 95% confidence interval (CI) 0.74-0.99, P = 0.047] or obese (HR = 0.83, 95% CI = 0.69-0.99, P = 0.047) was independently associated with lower 60-day in-hospital mortality, with normal BMI as the reference category. Risk of death increased in very obese patients, especially after neurosurgical procedures (HR = 0.3, 95% CI = 1.06-8.48, P = 0.039). CONCLUSION: In this cohort of surgical ICU patients, being overweight or obese was associated with decreased risk of 60-day in-hospital mortality. SN - 1432-1238 UR - https://www.unboundmedicine.com/medline/citation/21818652/The_obesity_paradox_in_surgical_intensive_care_unit_patients_ L2 - https://dx.doi.org/10.1007/s00134-011-2321-2 DB - PRIME DP - Unbound Medicine ER -