Shuhe Li1, Xiaoguang Hu2, Jinghong Xu3, Fa Huang4, Zilu Guo5, Li Tong6, Ka Yin Lui7, Lu Cao8, Yanping Zhu9, Jiyou Yao10, Xiaobin Lin11, Xiangdong Guan12, Changjie Cai13. 1. Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China. Electronic address: lish7@mail2.sysu.edu.cn. 2. Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China. Electronic address: huxiaog@mail2.sysu.edu.cn. 3. Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, 510080, China. Electronic address: xujh38@mail2.sysu.edu.cn. 4. Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China; Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, 510080, China. Electronic address: huangf56@mail2.sysu.edu.cn. 5. Department of Statistics, William March Rice University, 6100 Main St., Houston, TX 77005, USA. Electronic address: zg12@rice.edu. 6. Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China. Electronic address: tongli2@mail2.sysu.edu.cn. 7. Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China. Electronic address: lvjiax@mail2.sysu.edu.cn. 8. Department of Extracorporeal Circulation, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China. Electronic address: caolu3@mail2.sysu.edu.cn. 9. Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China. Electronic address: zhuyp8@mail2.sysu.edu.cn. 10. Department of Hepatobiliary Surgery, Guangzhou First People's Hospital, Guangzhou 510180, China. Electronic address: yaojy23@mail2.sysu.edu.cn. 11. Department of Pharmacology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China. Electronic address: linxb6@mail2.sysu.edu.cn. 12. Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China. Electronic address: carlg@163.com. 13. Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China. Electronic address: caichjie@mail.sysu.edu.cn.
Abstract
OBJECTIVES: We investigated the impact of obesity (proxied as body mass index (BMI)), on short- and long-term mortality in sepsis patients. METHODS: We conducted a retrospective analysis with adult sepsis ICU patients in a US medical institution from 2001 to 2012 in the MIMIC-III database. The WHO BMI categories were used. Multivariate logistic regression assessed the relationships between BMI and 30-day and 1-year mortality. RESULTS: In total, 5563 patients were enrolled. Obese patients tended to be younger (P<0.001), to be female (P<0.001), to acquire worse SOFA scores (P<0.001), and to receive more aggressive treatment compared with their normal weight counterparts. Obese patients had notably longer mechanical ventilation periods and ICU and hospital lengths of stay (LOSs). In the final model, overweight and obese patients had lower 30-day (OR 0.77, 95% CI 0.66-0.91; OR 0.65, 95% CI 0.56-0.77, respectively) and 1-year (OR 0.83, 95% CI 0.71-0.96; OR 0.70, 95% CI 0.60-0.81, respectively) mortality risks than normal weight patients. In contrast, underweight patients had worse 30-day and 1-year outcomes compared with normal weight patients (P=0.01, P<0.001, respectively). In morbidly obese, severe sepsis and septic shock patients, obesity remained protective. CONCLUSIONS: Obesity was correlated with short- and long-term survival advantages in sepsis patients.
OBJECTIVES: We investigated the impact of obesity (proxied as body mass index (BMI)), on short- and long-term mortality in sepsispatients. METHODS: We conducted a retrospective analysis with adult sepsis ICUpatients in a US medical institution from 2001 to 2012 in the MIMIC-III database. The WHO BMI categories were used. Multivariate logistic regression assessed the relationships between BMI and 30-day and 1-year mortality. RESULTS: In total, 5563 patients were enrolled. Obesepatients tended to be younger (P<0.001), to be female (P<0.001), to acquire worse SOFA scores (P<0.001), and to receive more aggressive treatment compared with their normal weight counterparts. Obesepatients had notably longer mechanical ventilation periods and ICU and hospital lengths of stay (LOSs). In the final model, overweight and obesepatients had lower 30-day (OR 0.77, 95% CI 0.66-0.91; OR 0.65, 95% CI 0.56-0.77, respectively) and 1-year (OR 0.83, 95% CI 0.71-0.96; OR 0.70, 95% CI 0.60-0.81, respectively) mortality risks than normal weight patients. In contrast, underweight patients had worse 30-day and 1-year outcomes compared with normal weight patients (P=0.01, P<0.001, respectively). In morbidly obese, severe sepsis and septic shockpatients, obesity remained protective. CONCLUSIONS:Obesity was correlated with short- and long-term survival advantages in sepsispatients.
Authors: Erick D Lewis; Holden C Williams; Maria E C Bruno; Arnold J Stromberg; Hiroshi Saito; Lance A Johnson; Marlene E Starr Journal: Shock Date: 2022-01-01 Impact factor: 3.454