HONOLULU – Having a higher body mass index is not significantly associated with hospital mortality among patients admitted to the surgical ICU.
While similar findings have been reported in medical ICUs, this is believed to be the largest study to investigate the relationship between BMI and mortality exclusively in a surgical ICU, Dr. Adam Khader said in an interview during a poster session at the annual meeting of the American College of Chest Physicians.
Dr. Adam Khader
Dr. Khader, a resident in the department of surgery at Hofstra North Shore–Long Island Jewish Medical Center, Manhasset, N.Y., and his associates evaluated the records of 1,860 patients admitted to the medical center’s surgical ICU. Patients younger than age 18 years and those who did not undergo surgery were excluded from the analysis. The researchers used area under the receiver operating characteristic curves to assess the effect of BMI on mortality and categorized patients as underweight (BMI less than 20 kg/m2), normal weight (20-25 kg/m2), overweight (25-30 kg/m2), obese (30-35 kg/m2), severely obese (35-50 kg/m2), and super obese (greater than 50 kg/m2).
Overall 30-day hospital mortality was 10%. Hospital mortality was 15% for underweight patients, 11% for normal weight patients, 8% for overweight patients, 9% for obese patients, 13% for severely obese patients, and 22% for super obese patients. Area under the receiver operating characteristic curve analysis yielded no significant association between BMI and mortality, even after stratification of patients by elective vs. emergent surgery, and patients younger vs. older than age 75 years.
Dr. Khader and his associates observed a trend toward increased mortality for patients in the underweight, obese, and severely obese categories of BMI, "but nothing statistically significant," he said. "Still, there was a large number of patients [in this study]. You can’t really ignore the numbers."
Dr. Khader said that he had no relevant financial conflicts to disclose.