Nasraway et al evaluated morbidly obese patients admitted to the intensive care unit (ICU) following surgery. They identified patients who may require more aggressive management. The authors are from Tufts-New England Medical Center and Central Florida Colon & Rectal Clinic, and Massachusetts General Hospital.


Patient selection: adult surgical patient with ICU admission >= 4 days


Risk factors for increased mortality in the multivariate model:

(1) body mass index (BMI) >= 40 kg per square meter

(2) age >= 55 years, with further increase if >= 70 years

(3) male gender

(4) MPM-24 mortality probability < 70%



• Mortality was very high if the BMI was > 60 kg per square meter.

• The fact that mortality was greater for a patient with a lower risk on the MPM-24 may indicate that complications occurred after 24 hours.


Additional factors seen on univariate analysis (indicators of organ failure):

(1) renal failure

(2) mechanical ventilation

(3) need for vasopressors


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