Literature DB >> 9403743

Relationship of body mass index to subsequent mortality among seriously ill hospitalized patients. SUPPORT Investigators. The Study to Understand Prognoses and Preferences for Outcome and Risks of Treatments.

A N Galanos1, C F Pieper, P S Kussin, M T Winchell, W J Fulkerson, F E Harrell, J M Teno, P Layde, A F Connors, R S Phillips, N S Wenger.   

Abstract

OBJECTIVE: To determine if body mass Index (BMI = weight [kg]/height [m]2), predictive of mortality in longitudinal epidemiologic studies, was also predictive of mortality in a sample of seriously ill hospitalized subjects.
DESIGN: Prospective, multicenter study.
SETTING: Five tertiary care medical centers in the United States. PATIENTS: Patients > or = 18 yrs of age who had one of nine illnesses of sufficient severity to anticipate a 6-month mortality rate of 50% were enrolled at five participating sites in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT).
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Patients were asked their current height and weight as part of the demographic data. Stratifying body mass index by percentile rank (< or = 15, 15 to 85, and > or = 85th percentiles), risk ratios for mortality were calculated by Cox Proportional Hazards using the 15th to 85th percentile of body mass index as the reference group while controlling for multiple variables such as prior weight loss, albumin, and Acute Physiology Score. A body mass index in the < or = 15th percentile was associated with an excess risk of mortality (risk ratio = 1.23; p < .001) within 6 months. High body mass index (> or = 85th percentile) was not significantly related to risk of mortality.
CONCLUSIONS: Body mass index, a simple anthropometric measure of nutrition employed in community epidemiologic studies, has now been demonstrated to be a predictor of mortality in an acutely ill population of adults at five different tertiary centers. Even when controlling for multiple disease states and physiologic variables and removing from the analysis all patients with significant prior weight loss, a body mass index below the 15th percentile remained a significant and independent predictor of mortality. Examination of patient vs. proxy data did not change the results. Future studies examining variables predictive of mortality should include body mass index, even in acutely ill populations with a poor probability of survival.

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Year:  1997        PMID: 9403743     DOI: 10.1097/00003246-199712000-00010

Source DB:  PubMed          Journal:  Crit Care Med        ISSN: 0090-3493            Impact factor:   7.598


  23 in total

Review 1.  Nutritional papers in ICU patients: what lies between the lines?

Authors:  Jean-Charles Preiser; René Chioléro; Jan Wernerman
Journal:  Intensive Care Med       Date:  2002-12-21       Impact factor: 17.440

Review 2.  Estimating deaths attributable to obesity in the United States.

Authors:  Katherine M Flegal; David F Williamson; Elsie R Pamuk; Harry M Rosenberg
Journal:  Am J Public Health       Date:  2004-09       Impact factor: 9.308

3.  The association between body-mass index and patient outcome in septic shock: a retrospective cohort study.

Authors:  Bettina Wurzinger; Martin W Dünser; Christoph Wohlmuth; Martina C Deutinger; Hanno Ulmer; Christian Torgersen; Christian A Schmittinger; Wilhelm Grander; Walter R Hasibeder
Journal:  Wien Klin Wochenschr       Date:  2010-01       Impact factor: 1.704

4.  ICU patients: fatter is better?

Authors:  Wilfred Druml
Journal:  Intensive Care Med       Date:  2008-08-01       Impact factor: 17.440

Review 5.  Nutritional assessment of residents in long-term care facilities (LTCFs): recommendations of the task force on nutrition and ageing of the IAGG European region and the IANA.

Authors:  A Salva; L Coll-Planas; S Bruce; L De Groot; S Andrieu; G Abellan; B Vellas; Sandrine Andrieu; Luisa Bartorelli; Ytshal N Berner; Stuart Bruce; Bruno Corman; Alex Domingo; Thomas P Egger; Lisette de Groot; Yves Guigoz; Ana Imedio; Mercè Planas; Concha Porras; Joan Carles Rovira; Antoni Salvà; José Antonio Serra; Bruno Vellas
Journal:  J Nutr Health Aging       Date:  2009-06       Impact factor: 4.075

Review 6.  Nutrition support for patients in the intensive care unit.

Authors:  R D Griffiths; T Bongers
Journal:  Postgrad Med J       Date:  2005-10       Impact factor: 2.401

7.  Impact of body weight and extreme obesity on the presentation, treatment, and in-hospital outcomes of 50,149 patients with ST-Segment elevation myocardial infarction results from the NCDR (National Cardiovascular Data Registry).

Authors:  Sandeep R Das; Karen P Alexander; Anita Y Chen; Tiffany M Powell-Wiley; Deborah B Diercks; Eric D Peterson; Matthew T Roe; James A de Lemos
Journal:  J Am Coll Cardiol       Date:  2011-12-13       Impact factor: 24.094

8.  The relationship between body mass index and postoperative mortality from critical illness.

Authors:  Fredric M Pieracci; Lynn Hydo; Alfons Pomp; Soumitra R Eachempati; Jian Shou; Philip S Barie
Journal:  Obes Surg       Date:  2008-05       Impact factor: 4.129

9.  Obesity is associated with increased morbidity but not mortality in critically ill patients.

Authors:  Yasser Sakr; Christian Madl; Daniela Filipescu; Rui Moreno; Johan Groeneveld; Antonio Artigas; Konrad Reinhart; Jean-Louis Vincent
Journal:  Intensive Care Med       Date:  2008-08-01       Impact factor: 17.440

10.  Recently published papers: Heavyweight problems in the intensive care unit?

Authors:  Lui G Forni
Journal:  Crit Care       Date:  2008-12-10       Impact factor: 9.097

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