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Prevalence of obesity and the effect on length of mechanical ventilation and length of stay in intensive care patients: A single site observational study.
Aust Crit Care. 2017 May; 30(3):145-150.AC

Abstract

OBJECTIVES

To provide a snapshot of the prevalence of abnormal body mass index (BMI) in a sample of intensive care unit (ICU) patients; to identify if any medical specialty was associated with abnormal BMI and to explore associations between BMI and ICU-related outcomes.

BACKGROUND

Obesity is an escalating public health issue across developed nations but there is little data pertaining to critically ill patients who require care that is expensive.

METHODS

Retrospective observational audit of 735 adult patients (median age 58 years) admitted to the Sir Charles Gairdner Hospital 23 bed tertiary ICU between November 2012 and June 2014. Primary outcome measure was patient BMI: underweight (<18.5kg/m2), normal weight (18.5-24.99kg/m2), overweight (25-29.99kg/m2), obese (30-39.99kg/m2) or extreme obese (40kg/m2 or above). Other measures included gender, acute physiology and chronic health evaluation II score, admission specialty, length of mechanical ventilation (MV), length of stay (LOS) and mortality.

RESULTS

Compared to the general population there was a higher proportion of obese patients within the cohort with the majority of patients overweight (33.9%) or obese (36.5%) and median BMI of 27.9 (IQR 7.9). There were no significant differences between specialties for BMI (p=0.103) and abnormal BMI was not found to impact negatively on mortality (ICU, p=0.373; hospital, p=0.330). Normal BMI patients had shorter length of MV than other BMI categories and the impact of BMI on ICU LOS was dependent on length of MV. Overweight patients ventilated for five days or more had a shorter LOS, and extremely obese non-ventilated patients had a longer LOS, compared to normal weight patients.

CONCLUSIONS

Although the obesity-disease relationship is increasingly complex and data presented reflects categorical BMI for patients admitted to a single ICU site it may be important to consider the cost implications of caring for this cohort especially with regard to MV and LOS.

Authors+Show Affiliations

Sir Charles Gairdner Hospital, Intensive Care Unit, Hospital Ave., Nedlands, WA 6009, Australia. Electronic address: Diane.Dennis@health.wa.gov.au.University of Western Australia, Centre for Applied Statistics, Stirling Highway, Crawley, WA 6009, Australia; Sir Charles Gairdner Hospital, Department of Research, Hospital Ave., Nedlands, WA 6009, Australia.Sir Charles Gairdner Hospital, Intensive Care Unit, Hospital Ave., Nedlands, WA 6009, Australia.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

27522470

Citation

Dennis, Diane M., et al. "Prevalence of Obesity and the Effect On Length of Mechanical Ventilation and Length of Stay in Intensive Care Patients: a Single Site Observational Study." Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses, vol. 30, no. 3, 2017, pp. 145-150.
Dennis DM, Bharat C, Paterson T. Prevalence of obesity and the effect on length of mechanical ventilation and length of stay in intensive care patients: A single site observational study. Aust Crit Care. 2017;30(3):145-150.
Dennis, D. M., Bharat, C., & Paterson, T. (2017). Prevalence of obesity and the effect on length of mechanical ventilation and length of stay in intensive care patients: A single site observational study. Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses, 30(3), 145-150. https://doi.org/10.1016/j.aucc.2016.07.003
Dennis DM, Bharat C, Paterson T. Prevalence of Obesity and the Effect On Length of Mechanical Ventilation and Length of Stay in Intensive Care Patients: a Single Site Observational Study. Aust Crit Care. 2017;30(3):145-150. PubMed PMID: 27522470.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of obesity and the effect on length of mechanical ventilation and length of stay in intensive care patients: A single site observational study. AU - Dennis,Diane M, AU - Bharat,Chrianna, AU - Paterson,Timothy, Y1 - 2016/08/10/ PY - 2016/02/09/received PY - 2016/07/15/revised PY - 2016/07/19/accepted PY - 2016/8/16/pubmed PY - 2018/4/6/medline PY - 2016/8/15/entrez KW - Body mass index KW - Critical care KW - Length of stay KW - Obesity SP - 145 EP - 150 JF - Australian critical care : official journal of the Confederation of Australian Critical Care Nurses JO - Aust Crit Care VL - 30 IS - 3 N2 - OBJECTIVES: To provide a snapshot of the prevalence of abnormal body mass index (BMI) in a sample of intensive care unit (ICU) patients; to identify if any medical specialty was associated with abnormal BMI and to explore associations between BMI and ICU-related outcomes. BACKGROUND: Obesity is an escalating public health issue across developed nations but there is little data pertaining to critically ill patients who require care that is expensive. METHODS: Retrospective observational audit of 735 adult patients (median age 58 years) admitted to the Sir Charles Gairdner Hospital 23 bed tertiary ICU between November 2012 and June 2014. Primary outcome measure was patient BMI: underweight (<18.5kg/m2), normal weight (18.5-24.99kg/m2), overweight (25-29.99kg/m2), obese (30-39.99kg/m2) or extreme obese (40kg/m2 or above). Other measures included gender, acute physiology and chronic health evaluation II score, admission specialty, length of mechanical ventilation (MV), length of stay (LOS) and mortality. RESULTS: Compared to the general population there was a higher proportion of obese patients within the cohort with the majority of patients overweight (33.9%) or obese (36.5%) and median BMI of 27.9 (IQR 7.9). There were no significant differences between specialties for BMI (p=0.103) and abnormal BMI was not found to impact negatively on mortality (ICU, p=0.373; hospital, p=0.330). Normal BMI patients had shorter length of MV than other BMI categories and the impact of BMI on ICU LOS was dependent on length of MV. Overweight patients ventilated for five days or more had a shorter LOS, and extremely obese non-ventilated patients had a longer LOS, compared to normal weight patients. CONCLUSIONS: Although the obesity-disease relationship is increasingly complex and data presented reflects categorical BMI for patients admitted to a single ICU site it may be important to consider the cost implications of caring for this cohort especially with regard to MV and LOS. SN - 1036-7314 UR - https://www.unboundmedicine.com/medline/citation/27522470/Prevalence_of_obesity_and_the_effect_on_length_of_mechanical_ventilation_and_length_of_stay_in_intensive_care_patients:_A_single_site_observational_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1036-7314(16)30065-0 DB - PRIME DP - Unbound Medicine ER -