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Clinical aspects of NIV
P152 Effect of obesity in patients admitted to Non invasive ventilation (NIV) Unit with acute hypercapnic respiratory failure (AHRF)
  1. C M Thippanna1,
  2. A Thomas1,
  3. W Tosh1,
  4. B Chakraborty2,
  5. B Beauchamp1,
  6. D Banerjee1,
  7. R Mukherjee1
  1. 1Heart of England NHS Foundation Trust, Birmingham, UK
  2. 2School of Mathematics, University of Birmingham, Birmingham, UK

Abstract

Introduction The prevalence of obesity, defined by the World Health Organization as a body mass index (BMI) greater than 30 kg/m2, is increasing in all developed countries. Obesity as the cause of admission or complicating in-patient stay has been increasing over the last decade. Obesity in intensive care unit (ICU) is significantly related to prolonged duration of mechanical ventilation and length of stay. Obesity is a known risk factor for acute hypercapnic respiratory failure (AHRF).

Methods An observational, single-centre, retrospective analysis of physician diagnosed obese patients requiring NIV for AHRF between April 2005 to March 2006 and April 2009 to March 2010. Demographic data including age, sex, height, weight, date of initiating NIV and length of stay in hospital were collected and BMI was calculated.

Results 154 patients were admitted in the period April 2005 to March 2006 and 160 patients in the period April 2009 to March 2010 to the dedicated NIV unit. The admissions to the unit with diagnosis of obesity in 2005–2006 and 2009–2010 are 7.14% and 15.63%, respectively. The admission rates with obesity have increased significantly in 2009–2010 compared to 2005–2006 with an OR of 2.52 (1.14 to 5.08) with a p-value of 0.021. Average length of stay in 2005–2006 is 20.6 days and in 2009–2010 19.9 days respectively. Average length of stay in non-obese patient during the same period is 8.9 days. There are a higher proportion of obese women as compared to men admitted to NIV unit in 2009–2010. Abstract P152 Table 1.

Conclusion There is a significant increase in number of admissions who are obese to the NIV unit. This is consistent with the observation that there is an increase in the BMI of acute general admissions. These cohorts of obese patients have a higher average length of stay and consume enormous amount of healthcare resources. Interventions to reduce obesity in the general public need to be taken up as a priority to preserve limited healthcare resources.

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