Impact of Obesity on Postoperative Intensive Care Unit Outcomes after Elective Surgery: A Retrospective Study

Abstract

Aim: Obesity is traditionally associated with increased perioperative risk and complex intensive care unit (ICU) management. However, its prognostic significance in surgical ICU patients remains controversial. This study aimed to evaluate the impact of obesity on postoperative ICU outcomes in patients undergoing elective surgery. Study Design: This retrospective cohort study analyzed adult patients who were intubated and admitted to the ICU after elective surgery between January 1 and December 31, 2023. Patients were classified as non-obese (Body Mass Index [BMI] <30 kg/m(2)) or obese (BMI >= 30 kg/m(2)). Demographic, clinical, and perioperative characteristics were recorded. Primary outcomes included ICU mortality, duration of mechanical ventilation, and ICU length of stay. Hemodynamic parameters and fluid balance were also assessed. Results: A total of 294 patients were included, 57.8% of whom were male. There were no significant differences between obese and non-obese patients in terms of ICU mortality (3.7% overall), mechanical ventilation duration, or ICU length of stay. Hemodynamic stability, including incidence of hypotension and use of vasoactive agents, was similar across groups. Notably, non-obese patients had a significantly higher rate of positive cumulative fluid balance (>= 5%, p=0.003), despite comparable total fluid volumes. Conclusions: Obesity, as defined by BMI, was not associated with increased ICU mortality, prolonged mechanical ventilation, or extended ICU stay following elective surgery. These findings suggest that BMI alone may not be a reliable predictor of adverse postoperative ICU outcomes, highlighting the importance of individualized risk assessment.