Association between Body Mass Index and Short-Term Clinical Outcomes in Critically Ill Patients with Sepsis: A Real-World Study.
Association between Body Mass Index and Short-Term Clinical Outcomes in Critically Ill Patients with Sepsis: A Real-World Study.
复制标题
体重指数与脓毒症危重患者短期临床结果之间的关联：一项真实世界研究
DOI：
10.1155/2020/5781913
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发表时间：
2020
影响因子：
--
通讯作者：
Zeng M
中科院分区：
文献类型：
--
作者：
Lin S;Ge S;He W;Zeng M
背景肥胖现在被认为是主要的公共卫生威胁之一，特别是对于患有危重病的患者。然而，关于体重指数（BMI）是否以及如何影响脓毒症患者的临床结局的研究仍然很少且存在争议。本研究的目的是确定BMI对重症脓毒症患者的影响。材料和方法我们使用来自重症监护医学信息中心III数据库的数据进行这项研究。多变量考克斯回归模型用于评估BMI与主要结局的独立相关性。结果共有7,967例患者入组本研究。首先，我们发现与正常体重相比，肥胖和超重的28天死亡率分别降低了22%（HR = 0.78，95% CI 0.69-0.88）和13%（HR = 0.87，95% CI 0.78-0.98）。随后，在脓毒症患者中观察到BMI与28天死亡率的U形关联，在30-40 kg/m2的BMI范围内28天死亡率最低。最后，仅在性别方面观察到显著的相互作用（P = 0.0071）。BMI为25-30 kg/m2（HR = 0.74，95% CI 0.63-0.86）和30-40 kg/m2（HR = 0.63，95% CI 0.53-0.76）的男性患者的28天死亡率风险显著降低。结论发现危重脓毒症患者的BMI与28天死亡率呈U型相关，BMI在30-40 kg/m2范围内的28天死亡率最低。值得注意的是，男性患者比女性患者更有效地受到较高BMI的保护，因为男性的死亡风险显著较低。
Background Obesity is now recognized as one of the major public health threats, especially for patients with a critical illness. However, studies regarding whether and how body mass index (BMI) affects clinical outcomes in patients with sepsis are still scarce and controversial. The aim of our study was to determine the effect of BMI on critically ill patients with sepsis. Materials and Methods We performed this study using data from the Medical Information Center for Intensive Care III database. A multivariate Cox regression model was used to assess the independent association of BMI with the primary outcome. Results A total of 7,967 patients were enrolled in this study. Firstly, we found that the 28-day mortality was reduced by 22% (HR = 0.78, 95% CI 0.69–0.88) and 13% (HR = 0.87, 95% CI 0.78–0.98) for obese and overweight compared to normal weight, respectively. Subsequently, a U-shaped association of BMI with 28-day mortality was observed in sepsis patients, with the lowest 28-day mortality at the BMI range of 30–40 kg/m2. Finally, significant interactions were observed only for sex (P = 0.0071). Male patients with a BMI of 25-30 kg/m2 (HR = 0.74, 95% CI 0.63–0.86) and 30-40 kg/m2 (HR = 0.63, 95% CI 0.53–0.76) had a significantly lower risk of 28-day mortality. Conclusions A U-shaped association of BMI with 28-day mortality in critically ill sepsis patients was found, with the lowest 28-day mortality at a BMI range of 30–40 kg/m2. Notably, male patients were protected by a higher BMI more effectively than female patients as males had a significantly lower mortality risk.
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影响因子：
9.8
作者：
Johnson AE;Pollard TJ;Shen L;Lehman LW;Feng M;Ghassemi M;Moody B;Szolovits P;Celi LA;Mark RG
通讯作者：
Mark RG
影响因子：
8.8
作者：
Akinnusi, Morohunfolu E.;Pineda, Lilibeth A.;El Solh, Ali A.
通讯作者：
El Solh, Ali A.
影响因子：
3.1
作者：
Hynninen, M;Pettilä, V;Valtonen, M
通讯作者：
Valtonen, M
DOI：
10.1186/s13054-016-1360-z
发表时间：
2016-06-15
期刊：
Critical care (London, England)
影响因子：
--
作者：
Pepper DJ;Sun J;Welsh J;Cui X;Suffredini AF;Eichacker PQ
通讯作者：
Eichacker PQ
影响因子：
8.8
作者：
Pepper, Dominique J.;Demirkale, Cumhur Y.;Kadri, Sameer S.
通讯作者：
Kadri, Sameer S.