Problem: Little is known about obese patients who have a prolonged intensive care unit (ICU) hospitalization. Purpose: This study uses an outcomes framework to describe the characteristics and outcomes of patients with a body mass index (BMI) &ge 30 kg/m2 from an urban, teaching hospital who experienced an ICU stay of 3 or more days. Methods: This is a secondary analysis of data from a larger descriptive study that examined adult failure to thrive in 400 patients experiencing a minimum of 3 days of mechanical ventilation. Results: 132 chronically critically ill obese patients were enrolled. 86 (65%) were female; 77 (58%) were Caucasian; and the average age was 60 years. 52 (40%) were admitted with a primary cardiorespiratory diagnosis. The mean APACHE 3 score was 77.5 for the entire sample. Nearly all subjects (99%) had at least one pre-existing condition (median number of conditions=6). The average BMI was 38.7 kg/m2. Subjects were mechanically ventilated for a mean of 12 days, with a mean ICU stay of 17 days and hospital length of stay of 25 days. 97(74%) of subjects were ultimately returned to spontaneous ventilation. 35 subjects (27%) died during hospitalization. Regression analysis indicates that 20% of mortality is explained by age and pre-existing congestive heart failure (beta 1.035 and 3.577, respectively, p < 0.05). Subjects in the parent study with a BMI < 30kg/m2 had a higher mortality rate than obese subjects (chi=8.497, p=0.04). Conclusions: This sample is younger, more likely to be female and be admitted with a higher acuity of illness than the “typical” ICU population. Compared to other chronically critically ill patients in the parent study and other reports, obese chronically critically ill patients appear to have a slightly longer duration of mechanical ventilation and length of stay but increased survivability. Acknowledgements: Funded by the NINR (R01NR05005), Patricia Higgins, Principle Investigator
Session #1219 - Poster Session I
The 29th Annual MNRS Research Conference (April 1-4, 2005)