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The effect of body mass index on intubation success rates and complications during emergency airway management

  • EM - AIRWAY FORUM
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Abstract

We evaluated the effect of body mass index (BMI) on intubation success rates and complications during emergency airway management. We retrospectively analyzed an airway registry at an academic medical center. The primary outcomes were the incidence of difficult intubation and complication rates, stratified by BMI. We captured 1,075 (98 %, 1,075/1,102; 95 % CI 97–99) intubations. Four hundred twenty-six patients (40 %) had a normal BMI, 289 (27 %) were overweight, 261 (25 %) were obese, and 77 (7 %) were morbidly obese. In a multivariate analysis, obesity (OR 1.90; 95 % CI 1.04–3.45; p = 0.04), but not morbid obesity (OR 2.18; 95 % CI 0.95–4.99; p = 0.07), predicted difficult intubation. BMI was not predictive of post-intubation complications. Airway management in the morbidly obese differed when compared with lean patients, with less use of rapid sequence intubation and increased use of fiberoptic bronchoscopy in the former. During emergency airway management, difficult intubation is more common in obese patients, and morbidly obese patients are more commonly treated as potentially difficult airways.

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Acknowledgments

We would like to acknowledge the hard work of several physicians who were instrumental in the development and data collection of this airway registry: Hiro Sung, MD, Vidya Rao, MD, MBA, Leo Shum, MD.

Conflict of interest

No external funding and no competing interests declared.

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Authors and Affiliations

  1. Department of Medicine, Division of Pulmonary-Critical Care Medicine, Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA, 01805, USA

    James M. Dargin

  2. Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Lillian L. Emlet

  3. Department of Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Frank X. Guyette

Authors
  1. James M. Dargin
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  2. Lillian L. Emlet
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  3. Frank X. Guyette
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Corresponding author

Correspondence to James M. Dargin.

Additional information

The work was performed at University of Pittsburgh Medical Center.

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Dargin, J.M., Emlet, L.L. & Guyette, F.X. The effect of body mass index on intubation success rates and complications during emergency airway management. Intern Emerg Med 8, 75–82 (2013). https://doi.org/10.1007/s11739-012-0874-x

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  • DOI: https://doi.org/10.1007/s11739-012-0874-x

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