The Impact of Obesity on the Outcome of Emergency Intubation in Trauma Patients

Abstract

Emergency intubation of obese trauma patients can be safely and successfully performed in a high volume Level I trauma center. Obesity is not a predictor of postintubation airway complications or mortality. Larger studies are needed to validate these finding in the morbidly obese patients.

Association of Injury Factors, Not Body Mass Index, With Hospital Resource Usage in Trauma Patients

“…30 Dhungel et 44 determined that hospital length of stay, ICU length of stay, and duration of mechanical ventilation did not differ significantly between normal weight, overweight, obese, and morbidly obese patients. In addition, studies 5,25,45 have indicated that with adjustments for ISS, BMI is not a significant factor in determining mortality. Furthermore, in many studies, 7,9,[16][17][18] obese patients had more complications than did nonobese patients.…”

“…However, we found that within all populations (nonobese, obese, and morbidly obese), the number of physiological complications influenced ICU length of stay and number of procedures. In contrast to many researchers who investigated hospital resource usage as a single outcome (eg, total hospital length of stay, ICU length of stay), 3,7,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]30 we used canonical correlation analyses to examine the complex relationship between patient/injury characteristics and the multifaceted nature of hospital resources.…”

“…BMI stratifications were grouped into 3 categories on the basis of previous research for multivariate analysis: nonobese, 3,[8][9][10]12,15,19,22,26 obese, and morbidly obese. 17,25,27,44 Analyses were completed on each weight classification. Statistical significance was set at P < .05.…”

“…Several studies have indicated that obese trauma patients are more likely than nonobese patients to have longer stays in the intensive care unit (ICU) 7,[9][10][11] and hospital, 9,11-13 more days of mechanical ventilation, 7,14 more complications 7,9,[15][16][17][18] and comorbid conditions, 16 and higher mortality. 7,16,[18][19][20][21][22] Other studies have indicated no differences between obese and nonobese patients in mortality, 10,11,17,[23][24][25][26] length of stay in the ICU 13,27 and the hospital, 20,22,26 duration of mechanical ventilation, 11,13,27 complications, 11,22,24,26 or comorbid conditions. 3 Care of critically ill trauma patients is resource intensive, technically involved, and expensive because of the need for highly trained staff and modern equipment and the use of diagnostic tests, pharmaceutical agents, and interventions.…”

“…29 In previous research on the effect of a patient's BMI on resource usage, each usage outcome was assessed independently of other resource usage variables. In those studies, 3,7,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]30 resource usage was evaluated as a secondary outcome by using familiar statistical analyses (t test, analysis of variance, regression analysis) suitable for the research questions. However, in order to best ascertain the association between the complex, multifaceted relationship of patient/ injury characteristics and hospital resource usage, the use of multivariate canonical correlation analyses is suggested.…”