The impact of obesity on outcomes after critical illness: a meta-analysis
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To assess whether obesity is associated with mortality or other adverse intensive care unit (ICU) and post-ICU outcomes.
A meta-analysis of studies from PubMed and EMBASE databases.
Twenty-two studies (n = 88,051 patients) were included. Pooled analysis demonstrated no difference in ICU mortality, but lower hospital mortality for obese and morbidly obese subjects (RR 0.76; 95% CI 0.59, 0.92; RR 0.83; 95% CI 0.66, 1.04, respectively) versus normal weight subjects. There was no association between obesity and duration of mechanical ventilation or ICU stay. Morbidly obese versus normal weight patients had longer hospitalizations. No study reported physical function, mental health, or quality of life outcomes after discharge.
Obesity is not associated with increased risk for ICU mortality, but may be associated with lower hospital mortality. There is a critical lack of research on how obesity may affect complications of critical illness and patient long-term outcomes.
KeywordsIntensive care Critical illness Mortality Body weight Meta-analysis
- 7.Marik P, Doyle H, Varon J (2003) Is obesity protective during critical illness? An analysis of a National ICU database. Crit Care Shock 6:156–162Google Scholar
- 11.Bochicchio G, Joshi M, Bochicchio K, Nehman S, Tracy J, Scalea T (2006) Impact of obesity in the critically ill trauma patient: a prospective study. J Am Coll Surg 203Google Scholar
- 15.Cheung A, Tansey C, Tomlinson G, Diaz-Granados N, Matté A, Barr A, Mehta S, Mazer C, Guest C, Stewart T, Al-Saidi F, Cooper A, Cook D, Slutsky A, MS H (2006) Two-year outcomes, health care use, and costs of survivors of acute respiratory distress syndrome. Am J Respir Crit Care Med 174:538–544PubMedCrossRefGoogle Scholar
- 17.Wells G, O’Connell D, Peterson J, Welch V, Tugwell P (2000) The Newcastle-Ottawa scale for re-assessing the quality of nonrandomised studies in meta-analysis. http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm
- 23.O’Brien J Jr, Welsh C, Fish R, Ancukiewicz M, Kramer A, National Heart L, and Blood Institute Acute Respiratory Distress Syndrome Network (2004) Excess body weight is not independently associated with outcome in mechanically ventilated patients with acute lung injury. Ann Intern Med 140:338–345Google Scholar
- 28.Alban R, Lyass S, Margulies D, Shabot M (2006) Obesity does not affect mortality after trauma. Am Surg 10:966–969Google Scholar
- 36.Rice T (2007) Obesity in acute lung injury: the “weight” is over. Chest 131:333–334Google Scholar
- 46.Sullivan M, Karlsson J, Sjöström L, Backman L, Bengtsson C, Bouchard C, Dahlgren S, Jonsson E, Larsson B, Lindstedt S (1993) Swedish obese subjects (SOS)—an intervention study of obesity. Baseline evaluation of health and psychosocial functioning in the first 1743 subjects examined. Int J Obes Relat Metab Disord 17:503–512PubMedGoogle Scholar