Impact of Obesity in Patients Infected With 2009 Influenza A(H1N1)-猫眼课题宝

DOI：

10.1378/chest.10-1160

发表时间：

2011-02-01

期刊：

CHEST

影响因子：

9.6

通讯作者：

中科院分区：

医学1区

文献类型：

作者：

Diaz, Emili;Rodriguez, Alejandro;Rello, Jordi

目的：2009年甲型H1N1流感（A[H1N1]）感染者中有很大一部分是肥胖的。肥胖被认为是影响这些患者预后的一个危险因素。但其作用仍不明确。我们评估肥胖和感染A（H1N1）在ICU的患者的结局，确定肥胖是否是死亡率的危险因素。方法：这是一项前瞻性，观察性和多中心研究，在144个ICU在西班牙进行。数据来自Grupo de Trabajo en Enfermedades Emergenciosas de la Sociedad Espanola de Medicina Intensiva，Critica y Unidades Coronarias（GTEI/SEMICYUC）登记研究。经实时聚合酶链反应证实的成人甲型H1N1流感患者也被纳入分析。将肥胖患者（BMI > 30）与非肥胖患者进行比较。采用考克斯回归分析确定校正死亡率。结果：2010年1月，GTEI/SEMICYUC登记处有416例患者的完整记录。150例患者（36.1%）为肥胖，其中67例（44.7%）为病态肥胖（BMI > 40）。机械通气（MV）更常用于肥胖患者（64%vs52.4%，P <0.01）肥胖患者维持MV的时间长于非肥胖患者（6.5 +/- 10.3天vs 9.3 +/- 9.7天，P = 0.02），ICU住院时间较长（10.8 +/- 12.1天vs 13.7 +/- 11.7天，P = .03），住院时间更长（18.2 +/- 14.6天vs 22.2 +/- 16.5天，P = .02）。经严重程度和潜在混杂因素校正的死亡率表明，肥胖与ICU死亡率无显著相关性（风险比，1.1; 95%CI，0.69-1.75; P = 0.68）。结论：在我们的队列中，肥胖并感染甲型H1N1流感的患者死亡率并未增加。然而，肥胖与ICU资源消耗较高之间存在关联。胸部2011;139（2）：382-386

Objective: A large proportion of patients infected with 2009 influenza A(H1N1) (A[H1N1]) are obese. Obesity has been proposed as a risk factor influencing outcome in these patients. However, its role remains unclear. We evaluate the outcome of patients who are obese and infected with A(H1N1) in the ICU, determining whether obesity is a risk factor for mortality.Methods: This was a prospective, observational, and multicenter study performed in 144 ICUs in Spain. Data were obtained from the Grupo de Trabajo en Enfermedades Infecciosas de la Sociedad Espanola de Medicina Intensiva, Critica y Unidades Coronarias (GTEI/SEMICYUC) registry. Adult patients with A(H1N1) that was confirmed by real-time polymerase chain reaction were included in the analysis. Patients who were obese (BMI > 30) were compared with patients who were nonobese. Cox regression analysis was used to determine adjusted mortality. Differences of P < .05 were considered significant.Results: In January 2010, the GTEI/SEMICYUC registry had complete records for 416 patients. One hundred and fifty patients (36.1%) were obese, of whom 67 (44.7%) were morbidly obese (BMI > 40). Mechanical ventilation (MV) was more frequently applied in patients who were obese (64% vs 52.4%, P < .01) Patients with obesity remained on MV longer than patients who were nonobese (6.5 +/- 10.3 days vs 9.3 +/- 9.7 days, P = .02), had longer ICU length of stay (10.8 +/- 12.1 days vs 13.7 +/- 11.7 days, P = .03), and had longer hospitalization (18.2 +/- 14.6 days vs 22.2 +/- 16.5 days, P = .02). Mortality adjusted by severity and potential confounders identified that obesity was not significantly associated with ICU mortality (hazard ratio, 1.1; 95% CI, 0.69-1.75; P = .68).Conclusions: In our cohort, patients who were obese and infected with A(H1N1) did not have increased mortality. However, there was an association between obesity and higher ICU resource consumption. CHEST 2011;139(2):382-386

Impact of Obesity in Patients Infected With 2009 Influenza A(H1N1)

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