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

被引:119
|
作者
Sakr, Yasser [2 ]
Madl, Christian [3 ]
Filipescu, Daniela [4 ]
Moreno, Rui [5 ]
Groeneveld, Johan [6 ]
Artigas, Antonio [7 ]
Reinhart, Konrad [2 ]
Vincent, Jean-Louis [1 ]
机构
[1] Univ Libre Bruxelles, Hop Erasme, Dept Intens Care, B-1070 Brussels, Belgium
[2] Univ Jena, Dept Anaesthesia & Intens Care, Jena, Germany
[3] Med Univ Vienna, Intens Care Unit 13H1, Dept Internal Med 4, Vienna, Austria
[4] Inst Cardiovasc Dis, Dept Anesthesiol & Cardiac Intens Care, Bucharest, Romania
[5] Hosp St Antonio Capuchos, Dept Intens Care, Lisbon, Portugal
[6] Vrije Univ Amsterdam Med Ctr, Dept Intens Care, Amsterdam, Netherlands
[7] Sabadell Hosp, Dept Intens Care, Sabadell, Spain
关键词
Body mass index; Multicentre; Outcome; Intensive care; Nosocomial infection;
D O I
10.1007/s00134-008-1243-0
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: To investigate the possible impact of obesity on morbidity and mortality in intensive care unit (ICU) patients included in the European observational sepsis occurrence in acutely ill patients (SOAP) study. Design: Planned substudy from the SOAP database. Setting: One hundred and ninety-eight ICUs in 24 European countries. Patients: All patients admitted to one of the participating ICUs. Patients were classified, according to their body mass index (BMI), as underweight (< 18.5 kg/m(2)), normal weight (18.5-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), obese (30-39.9 kg/m(2)), and very obese (>= 40 kg/m(2)). Measurements and results: The BMI was available in 2,878 (91%) of the 3,147 patients included in the SOAP study; 120 patients (4.2%) were underweight, 1,206 (41.9%) had a normal BMI, 1,047 (36.4%) were overweight, 424 (14.7%) were obese, and 81 (2.8%) were very obese. Obese and very obese patients more frequently developed ICU-acquired infections than patients in lower BMI categories. Very obese patients showed a trend towards longer ICU [median (IQ): 4.1 (1.8-12.1) vs. 3.1 (1.7-7.2) days, P = 0.056) and hospital lengths of stay [14.3 (8.4-27.4) vs. 12.3 (5.1-24.4), days P = 0.077] compared to those with a normal BMI. However, there were no significant differences among the groups in ICU or hospital mortality rates. In a multivariate Cox regression analysis, none of the BMI categories was associated with an increased risk of 60-day in-hospital death. Conclusion: BMI did not have a significant impact on mortality in this mixed population of ICU patients.
引用
收藏
页码:1999 / 2009
页数:11
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