Researchers have discovered that obese adults undergoing surgery are less frequently developing respiratory insufficiency (RI) and adult respiratory distress syndrome (ARDS), and that when they do, they are less likely to have fatal outcomes. The researchers say they have several theories of how obesity protects patients from mortality associated with RI/ARDS, and pinpointing the protective mechanism could help them develop interventions to help non-obese patients avoid adverse outcomes. The finding comes from a study published online ahead of print in the Journal of Intensive Care Medicine.
"Although the assumption is that patients with obesity have worse perioperative and long-term outcomes, this study clearly shows that in the setting of RI/ARDS, this is not the case and obesity might actually be protective in this setting," said Stavros G. Memtsoudis, M.D., Ph.D., an anesthesiologist at Hospital for Special Surgery, who led the study.
Many factors associated with surgical procedures, including the release of inflammatory mediators, can cause lung inflammation that leads to RI/ARDS. ARDS is a life-threatening lung condition that prevents enough oxygen from getting into the blood. For their study, the researchers used a large national database sponsored by the Agency for Healthcare Research and Quality to identify patients between 1998 and 2007 who underwent common surgical procedures known to have a high risk of leading to RI/ARDS. Procedure types included open abdominal, laparoscopic abdominal, hip and knee arthroplasty, spine, cardiac, thoracic, major vascular, and surgeries of the head and neck. They identified roughly 9 million patients who underwent these procedures. Because the database includes only about 20% of patients in the United States, the national estimate would be roughly 45 million.
The researchers found that 5.48% of patients had a diagnosis of obesity, and the incidence of RI/ARDS was 1.82% among obese
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Hospital for Special Surgery