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Clinical Investigations in Critical CareMorbid Obesity in the Medical ICU
Section snippets
Patients
After obtaining Institutional Review Board approval from the University at Buffalo, we have reviewed the medical records of all hospitalized morbidly obese adults patients admitted to the medical ICUs of two university affiliated hospitals. Both hospitals (Erie County Medical Center and the Buffalo General Hospital) are tertiary-care centers with separate medical and surgical ICUs managed by house-staff and critical-care attending physicians. The degree of obesity was assessed by the body mass
Demographic Characteristics
There were 132 critically ill morbidly obese patients admitted to the ICU of 9,727 ICU admissions between January 1994 and June 2000. Three patients remained in the ICU for < 24 h, and 12 patients had more than one hospital admission, leaving 117 patients eligible for analysis. Nine of 117 (8%) patients were transferred from the medical wards of the same hospital, and 108 patients (92%) were admitted from the emergency department. In the nonobese group, 14 patients (11%) were in-hospital
Discussion
This study, one of the largest unicenter studies, including 117 consecutive hospitalized patients, provides a comprehensive insight about the morbidity and mortality of the critically ill morbidly obese patients in the ICU. The main findings were as follows: (1) critically ill morbidly obese patients have higher ICU mortality compared to nonobese patients, (2) morbidly obesity is associated with prolonged mechanical ventilation and extended “weaning” period, (3) MOF remains the best predictor
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This study was supported by a grant from the Research for Health in Erie County.