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Obese cardiac surgery patients need ‘significantly more’ intensive care

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Obese patients who have undergone heart surgery tend to require additional intensive care unit (ICU) services and longer recovery times, compared to non-obese patients, a study has found.

The Canadian researchers noted that this resulted in more expensive, more labour-intensive care.

”By working with their healthcare providers, patients can learn how to achieve and maintain a healthy body weight”

Brandon Rosvall

They looked at data on patients who underwent cardiac surgery during 2006-13, including information on their ICU stays.

Of the 5,365 patients included in the final analysis, 36% were classified as obese, according to the study published in the Annals of Thoracic Surgery.

The study showed that, following surgery, patients with higher levels of obesity were four times more likely to require extra time in the ICU.

They were also three times more likely to need additional time on mechanical ventilation, and three times more likely to be re-admitted to the ICU.

In addition, the researchers found that such patients experienced longer overall hospital lengths of stay and discharges with home care.

“By more efficiently using ICU resources, we can save the healthcare system money”

Brandon Rosvall

Lead study author Brandon Rosvall said: “We saw that as patients became more obese, the hospital resources required to care for them after heart surgery also increased.

“Patients should be aware that obesity may negatively impact recovery from heart surgery,” said Mr Rosvall.

“More in-depth conversations regarding surgical risks and alternatives to surgery should take place with obese patients so that they are aware of the true impact of increased obesity,” he said.

“While obesity has become a social issue, it is one that can be addressed on a personal level. By working with their healthcare providers, patients can learn how to achieve and maintain a healthy body weight,” he added.

The researchers also said that strategies should be developed that improve ICU resource use among patients with increased BMI.

For example, they suggested that knowing that obese patients spent more time in the ICU after surgery enabled providers to better predict bed vacancies and adapt the scheduling of staff.

Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada

Obese surgery patients need ‘much more’ ICU care

Brandon Rosvall

Efficient booking allowed more patients to be treated, while preventing overworked staff and cancelled procedures, noted the study authors.

In addition, they cited pre-emptive actions that clinicians should put into practice, such as closer monitoring of obese patients and pre-operative discussions about their unique surgical risks.

“The ICU provides a number of highly specialised services to care for patients who are seriously ill,” said Mr Rosvall. “Expensive resources including staff, medical equipment, and medication are needed to provide these services.

“Healthcare is costly, so by more efficiently using ICU resources, we can save the healthcare system money, while also improving overall patient care,” he added.

The researchers are currently conducting a new study on biomarkers that will help clinicians predict how obese patients will recover from cardiac surgery.

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