Faculty Collaboration Database

Outcomes of In-Hospital Cardiopulmonary Resuscitation in Morbidly Obese Patients. JACC Clin Electrophysiol 2017 Feb;3(2):174-183

Date

02/01/2017

Pubmed ID

29759391

DOI

10.1016/j.jacep.2016.08.011

Scopus ID

2-s2.0-85007211596 (requires institutional sign-in at Scopus site)   11 Citations

Abstract

OBJECTIVES: This study sought to assess the impact of morbid obesity on outcomes in patients with in-hospital cardiac arrest (IHCA).

BACKGROUND: Obesity is associated with increased risk of out-of-hospital cardiac arrest; however, little is known about survival of morbidly obese patients with IHCA.

METHODS: Using the Nationwide Inpatient Sample database from 2001 to 2008, we identified adult patients undergoing resuscitation for IHCA, including those with morbid obesity (body mass index ≥40 kg/m²) by using International Classification of Diseases 9th edition codes and clinical outcomes. Outcomes including in-hospital mortality, length of stay, and discharge dispositions were identified. Logistic regression model was used to examine the independent association of morbid obesity with mortality.

RESULTS: Of 1,293,071 IHCA cases, 27,469 cases (2.1%) were morbidly obese. The overall mortality was significantly higher for the morbidly obese group than for the nonobese group experiencing in-hospital non-ventricular fibrillation (non-VF) (77% vs. 73%, respectively; p = 0.006) or VF (65% vs. 58%, respectively; p = 0.01) arrest particularly if cardiac arrest happened late (>7 days) after hospitalization. Discharge to home was significantly lower in the morbidly obese group (21% vs. 31%, respectively; p = 0.04). After we adjusted for baseline variables, morbid obesity remained an independent predictor of increased mortality. Other independent predictors of mortality were age and severe sepsis for non-VF and VF group and venous thromboembolism, cirrhosis, stroke, malignancy, and rheumatologic conditions for non-VF group.

CONCLUSIONS: The overall mortality of morbidly obese patients after IHCA is worse than that for nonobese patients, especially if IHCA occurs after 7 days of hospitalization and survivors are more likely to be transferred to a skilled nursing facility.

Author List

Shahreyar M, Dang G, Waqas Bashir M, Kumar G, Hussain J, Ahmad S, Pandey B, Thakur A, Bhandari S, Thandra K, Sra J, Tajik AJ, Jahangir A

Author

Sanjay Bhandari MD Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cardiopulmonary Resuscitation
Female
Heart Arrest
Hospital Costs
Humans
Length of Stay
Male
Middle Aged
Obesity, Morbid
Patient Transfer
Treatment Outcome
United States
Ventricular Fibrillation