title: Impact of Obesity on Outcomes in a Multiethnic Cohort of Medical Intensive Care Unit Patients.
abstract: OBJECTIVE
  To examine the association of obesity with in-hospital mortality and complications during critical illness.
  
  
  METHODS
  We performed a retrospective analysis of a multiethnic cohort of 699 patients admitted to medical intensive care unit between January 2010 and May 2011 at Mount Sinai St. Luke's and Mount Sinai West Hospitals, tertiary care centers in New York City. Multivariate logistic regression analysis was used to evaluate the association between obesity (body mass index [BMI] ≥ 30] and in-hospital mortality. Subgroup analysis was performed in elderly patients (age ≥65 years).
  
  
  RESULTS
  Compared to normal BMI, obese patients had lower in-hospital mortality (24.4% vs 17.6%, P = .04). On multivariate analysis, obesity was independently associated with lower in-hospital mortality (odds ratio [OR]: 0.49, 95% confidence interval [CI]: 0.27-0.89, P = .018). There was no significant difference in rates of mechanical ventilation, reintubation, and vasopressor requirement across BMI categories. In subgroup analysis, elderly obese patients did not display lower in-hospital mortality (adjusted OR: 0.85, 95% CI: 0.40-1.82, P = .68).
  
  
  CONCLUSIONS
  Our study supports the hypothesis that obesity is associated with decreased mortality during critical illness. However, this finding was not observed among elderly obese patients. Further studies should explore the interaction between age, obesity, and outcomes in critical illness.
authors.affiliation: 1 Division of Pulmonary and Critical Care Medicine, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, NY, USA.|2 Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Vrinda
authors.initials: V
authors.lastname: Trivedi
authors.affiliation: 1 Division of Pulmonary and Critical Care Medicine, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, NY, USA.
authors.forename: Raymonde E
authors.initials: RE
authors.lastname: Jean
authors.affiliation: 1 Division of Pulmonary and Critical Care Medicine, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, NY, USA.
authors.forename: Frank
authors.initials: F
authors.lastname: Genese
authors.affiliation: 1 Division of Pulmonary and Critical Care Medicine, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, NY, USA.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Fuhrmann
authors.affiliation: 1 Division of Pulmonary and Critical Care Medicine, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, NY, USA.
authors.forename: Anjeet K
authors.initials: AK
authors.lastname: Saini
authors.affiliation: 3 Division of Pulmonary and Critical Care Medicine, Keck Hospital of University of Southern California, Los Angeles, CA, USA.
authors.forename: Van Derick
authors.initials: VD
authors.lastname: Mangulabnan
authors.affiliation: 1 Division of Pulmonary and Critical Care Medicine, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, NY, USA.
authors.forename: Chirag
authors.initials: C
authors.lastname: Bavishi
mesh_terms: D018806:APACHE; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015331:Cohort Studies; D016638:Critical Illness / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009519:New York City / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology*; D016017:Odds Ratio; D011379:Prognosis; D065840:Protective Factors; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
chemical_list: D014662:Vasoconstrictor Agents
keywords: BMI; critical illness; hospital mortality; obesity