Internal and Emergency Medicine

, Volume 8, Issue 1, pp 75–82 | Cite as

The effect of body mass index on intubation success rates and complications during emergency airway management

  • James M. Dargin
  • Lillian L. Emlet
  • Frank X. Guyette


We evaluated the effect of body mass index (BMI) on intubation success rates and complications during emergency airway management. We retrospectively analyzed an airway registry at an academic medical center. The primary outcomes were the incidence of difficult intubation and complication rates, stratified by BMI. We captured 1,075 (98 %, 1,075/1,102; 95 % CI 97–99) intubations. Four hundred twenty-six patients (40 %) had a normal BMI, 289 (27 %) were overweight, 261 (25 %) were obese, and 77 (7 %) were morbidly obese. In a multivariate analysis, obesity (OR 1.90; 95 % CI 1.04–3.45; p = 0.04), but not morbid obesity (OR 2.18; 95 % CI 0.95–4.99; p = 0.07), predicted difficult intubation. BMI was not predictive of post-intubation complications. Airway management in the morbidly obese differed when compared with lean patients, with less use of rapid sequence intubation and increased use of fiberoptic bronchoscopy in the former. During emergency airway management, difficult intubation is more common in obese patients, and morbidly obese patients are more commonly treated as potentially difficult airways.


Obesity Body mass index Airway Intubation Endotracheal Emergency 



We would like to acknowledge the hard work of several physicians who were instrumental in the development and data collection of this airway registry: Hiro Sung, MD, Vidya Rao, MD, MBA, Leo Shum, MD.

Conflict of interest

No external funding and no competing interests declared.


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Copyright information

© SIMI 2012

Authors and Affiliations

  • James M. Dargin
    • 1
  • Lillian L. Emlet
    • 2
  • Frank X. Guyette
    • 3
  1. 1.Department of Medicine, Division of Pulmonary-Critical Care MedicineLahey Clinic Medical CenterBurlingtonUSA
  2. 2.Department of Critical Care MedicineUniversity of Pittsburgh Medical CenterPittsburghUSA
  3. 3.Department of Emergency MedicineUniversity of Pittsburgh Medical CenterPittsburghUSA

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