Lower In-Hospital Mortality for Obese Patients With RI/ARDS
Significant reduction of in-hospital mortality odds in obese postoperative patients with RI/ARDS
MONDAY, July 25 (HealthDay News) -- Obesity is associated with a decreased incidence of in-hospital mortality in patients who develop postoperative respiratory insufficiency (RI)/adult respiratory distress syndrome (ARDS), according to a study published online July 21 in the Journal of Intensive Care Medicine.
Stavros G. Memtsoudis, M.D., Ph.D., from the Hospital for Special Surgery in New York City, and colleagues examined the demographic profile of obese and non-obese individuals developing postoperative RI/ARDS and assessed the effect of obesity on in-hospital mortality in this population. Data from 9,149,030 patients, who underwent a surgical procedure between 1998 and 2007 and were diagnosed with RI/ARDS after surgery, were collected from the National Inpatient Sample. The primary outcome measured was in-hospital mortality.
The investigators found that 5.48 percent of the patients were obese. The incidence of RI/ARDS among obese and non-obese patients was 1.82 and 2.01 percent, respectively. The need for mechanical ventilation in obese patients whose postoperative course was complicated by RI/ARDS was significantly lower than in non-obese patients (50 versus 55 percent). In-hospital mortality was significantly lower for the obese patients than the non-obese patient (5.45 versus 18.72 percent). In-hospital mortality rates for all patients with RI/ARDS requiring intubation was 11 and 25 percent for obese and non-obese patients, respectively. In postoperative patients with RI/ARDS, obesity was associated with a 69 percent reduction in the odds of in-hospital mortality after adjusting for confounders.
"Obesity was associated with a decreased incidence and adjusted odds for in-hospital mortality after surgery. Our results support the emerging concept of the 'obesity paradox'," the authors write.