000			04283nam a22007217a 4500
008			141125s20142014 xxu||||| |||| 00| 0 eng d
022			_a0025-7931
040			_aOvid MEDLINE(R)
099			_a24457313
245			_aThe effect of obesity on outcomes in mechanically ventilated patients in a medical intensive care unit.
251			_aRespiration. 87(3):219-26, 2014.
252			_aRespiration. 87(3):219-26, 2014.
253			_aRespiration; international review of thoracic diseases
260			_c2014
260			_fFY2015
266			_d2014-11-25
520			_aBACKGROUND: The effect of obesity on outcomes in critically ill patients requiring invasive mechanical ventilation in a medical intensive care unit (ICU) is uncertain.
520			_aCONCLUSIONS: Obesity did not influence outcomes in critically ill patients requiring invasive mechanical ventilation in a medical ICU. Black obese patients had similar outcomes to black nonobese patients, and very obese patients also had similar outcomes to obese patients. 2013 S. Karger AG, Basel.
520			_aMETHODS: All adult patients admitted to the medical ICU at Washington Hospital Center requiring intubation and invasive mechanical ventilation for at least 24 h between January 1 and December 31, 2009, were retrospectively studied. Patients were categorized as nonobese (BMI <30) and obese (BMI >30). The primary outcome measure was 30-day mortality following intubation. Secondary outcomes included ICU length of stay (LOS), hospital LOS and duration of mechanical ventilation.
520			_aOBJECTIVES: This study was intended to further explore the relationship between outcomes and obesity in patients admitted to a medical ICU who required invasive mechanical ventilation.
520			_aRESULTS: There were 504 eligible patients: 306 nonobese and 198 (39%) obese. Obese patients had significantly higher rates of diabetes (43 vs. 30%, p = 0.004), hyperlipidemia (32 vs. 24%, p = 0.04), asthma (16 vs. 8%, p = 0.004) and obstructive sleep apnea requiring continuous positive airway pressure treatment (12 vs. 1%, p < 0.001). Nonobese patients had a significantly higher rate of HIV infection (10 vs. 5%, p = 0.05) and malignancy (21 vs. 13%, p = 0.03). There were no significant differences in mortality up to 30 days following intubation and secondary outcomes between obese and nonobese patients. Multivariate analysis using logistic regression showed no significant relationship between mortality rate at 30 days following intubation and obesity. Outcomes were similar for the black obese (n = 153) and nonobese (n = 228) patients and the obese (n = 85) and very obese (n = 113) patients.
546			_aEnglish
650			_a*Critical Illness/ep [Epidemiology]
650			_a*Obesity/ep [Epidemiology]
650			_a*Respiration, Artificial
650			_aAdult
650			_aAfrican Americans
650			_aAged
650			_aAPACHE
650			_aAsthma/ep [Epidemiology]
650			_aCohort Studies
650			_aComorbidity
650			_aCritical Illness/mo [Mortality]
650			_aCritical Illness/th [Therapy]
650			_aDiabetes Mellitus/ep [Epidemiology]
650			_aEuropean Continental Ancestry Group
650			_aFemale
650			_aHIV Infections/ep [Epidemiology]
650			_aHospital Mortality
650			_aHumans
650			_aHyperlipidemias/ep [Epidemiology]
650			_aIntensive Care Units
650			_aLength of Stay/sn [Statistics & Numerical Data]
650			_aLogistic Models
650			_aMale
650			_aMiddle Aged
650			_aMultivariate Analysis
650			_aNeoplasms/ep [Epidemiology]
650			_aRetrospective Studies
650			_aRisk Factors
650			_aSleep Apnea, Obstructive/ep [Epidemiology]
650			_aTreatment Outcome
651			_aMedStar Health Research Institute
651			_aMedStar Washington Hospital Center
656			_aMedicine/Pulmonary-Critical Care
657			_aJournal Article
657			_aResearch Support, Non-U.S. Gov't
700			_aColice, Gene L
700			_aTefera, Eshetu
790			_aColice G, Lee CK, Tefera E
856			_uhttp://dx.doi.org/10.1159/000357317 _zhttp://dx.doi.org/10.1159/000357317
942			_cART _dArticle
999			_c1543 _d1543