doi:10.5402/2012/743978 Research Article Not All Critically Ill Obese Patients Are the Same: The Influence of Prior Comorbidities

Copyright © 2012 Adam Rahman et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. Data suggest that obesity in critical illness is associated with improved outcomes. We postulate that these findings may be influenced by preillness comorbidities. We sought to determine if critically ill obese patients without significant comorbidity had improved mortality compared to obese patients with multiple comorbidities. Materials and Methods. We analyzed data from a prospective observational study conducted in 3 tertiary ICUs. Severely obese (body mass index ≥30) adults in the ICU for ≥24 hours were identified and classified into limited comorbid illnesses (0-1) or multiple comorbidities (≥2). The primary outcome was the odds ratio (OR) of mortality at day 28. Important secondary outcomes were ICU length of stay and ICU free days in the first 28 days. Results. 598 patients were enrolled; 183 had BMI ≥30. Of these, 38 had limited comorbidities and 145 had multiple comorbidities. In unadjusted analyses, obese patients with multiple comorbidities were 4.70 times (95 % CI 1.07–20.6) as likely to die by day 28 compared to patients with limited comorbidities (P = 0.04). After stratifying by admission diagnosis and adjustin