The effect of body mass index on patient outcomes in a medical ICU.
OBJECTIVE
To examine the effect of patient body mass index (BMI) on outcome in intensive care.


METHODS
In a prospective study, the patients were classified into groups based on the calculated BMI, as follows: BMI < 19.0 (n = 350), > or = 19.0 and < 25.0 (n = 663), > or = 25.0 and < 29.9 (n = 585), > or = 30.0 and < 40.0 (n = 396), and > or = 40.0 (n = 154). Groups were compared by age, APACHE (acute physiology and chronic health evaluation) II score, mortality, ICU length of stay (LOS), hospital LOS, number receiving ventilation, and ventilator-days. Adverse events including nosocomial pneumonia, ventilator-days per patient, failed extubations, and line-related complications were recorded.


METHODS
The study was conducted in a 9-bed medical ICU of a 650-bed tertiary care hospital.


METHODS
Height and weight were prospectively recorded for the first ICU admission during a hospital stay.


RESULTS
Between January 1, 1997, and August 1, 2001, 2,148 of 2,806 patients admitted to the ICU had height and weight recorded. There were no differences in APACHE II score, mortality, ICU LOS, hospital LOS, number receiving ventilation, ventilator-days, average total cost, or average variable cost among the five groups. However, the severely obese patients were more frequently female and younger than those who were overweight and obese (p < 0.001). Adverse events were infrequent, but there were no differences between the obese/very obese compared with others.


CONCLUSIONS
BMI has minimal effects on ICU outcome after patients are admitted to a critical care unit.
Ray
Daniel E
DE
Medical Critical Care, Lehigh Valley Hospital, Allentown, PA, USA. daniel.ray@lvh.com
Matchett
Stephen C
SC
Baker
Kathy
K
Wasser
Thomas
T
Young
Mark J
MJ
D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis*; D011336:Probability; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000592:standards / Q000639:trends; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome