The Association Between Body Mass Index and 28-day Mortality in Patients With Sepsis: A Retrospective Cohort Study.

IF 1 4区医学 Q3 SURGERY

American Surgeon Pub Date : 2024-11-28 DOI:10.1177/00031348241304040

Xu Zhang, Weiwei Yuan, Tingting Li, Haiwang Sha, Zhiyan Hui

{"title":"The Association Between Body Mass Index and 28-day Mortality in Patients With Sepsis: A Retrospective Cohort Study.","authors":"Xu Zhang, Weiwei Yuan, Tingting Li, Haiwang Sha, Zhiyan Hui","doi":"10.1177/00031348241304040","DOIUrl":null,"url":null,"abstract":"Background: Sepsis is a severe clinical syndrome with high morbidity and mortality in intensive care units (ICUs). Body Mass Index (BMI) shows a rising trend of obese patients being admitted to ICUs. The relationship between BMI and the clinical outcome of sepsis remains highly debated.Methods: The data used in this study were sourced from the Intensive Care Information Center IV (MIMIC-IV) database. Baseline information extracted within 24 hours of ICU admission was categorized according to World Health Organization (WHO)'s BMI classifications. A multivariate Cox regression model and curve fitting assessed the independent correlation between BMI and the primary outcome.Results: A total of 7836 patients were included in the study and categorized into five groups based on BMI. The overall 28-day mortality rate was 21.94% (1719/7836). Class I obesity (17.14%) and class II/III obesity (13.49%) individuals tended to be younger and male. Compared to patients with normal BMI (32.55%), those with low BMI (5.79%) had a 47% increased risk of 28-day mortality (HR 1.47, 95% CI 1.16-1.85, P = 0.0013), while class II/III obesity patients had a 17% lower 28-day mortality rate (HR 0.83, 95% CI 0.71-0.97, P = 0.0218). Curve fitting revealed a nonlinear relationship between BMI and 28-day mortality. The Kaplan-Meier survival analysis highlighted variations in survival rates across the five groups (P = 0.0123), with underweight patients exhibiting poorer survival outcomes.Conclusion: In sepsis patients, a low BMI is related to higher 28-day mortality compared to those with a normal BMI. Conversely, patients with a BMI≥35 kg/m2 have significantly reduced mortality risks.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348241304040"},"PeriodicalIF":1.0000,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Surgeon","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00031348241304040","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Sepsis is a severe clinical syndrome with high morbidity and mortality in intensive care units (ICUs). Body Mass Index (BMI) shows a rising trend of obese patients being admitted to ICUs. The relationship between BMI and the clinical outcome of sepsis remains highly debated.

Methods: The data used in this study were sourced from the Intensive Care Information Center IV (MIMIC-IV) database. Baseline information extracted within 24 hours of ICU admission was categorized according to World Health Organization (WHO)'s BMI classifications. A multivariate Cox regression model and curve fitting assessed the independent correlation between BMI and the primary outcome.

Results: A total of 7836 patients were included in the study and categorized into five groups based on BMI. The overall 28-day mortality rate was 21.94% (1719/7836). Class I obesity (17.14%) and class II/III obesity (13.49%) individuals tended to be younger and male. Compared to patients with normal BMI (32.55%), those with low BMI (5.79%) had a 47% increased risk of 28-day mortality (HR 1.47, 95% CI 1.16-1.85, P = 0.0013), while class II/III obesity patients had a 17% lower 28-day mortality rate (HR 0.83, 95% CI 0.71-0.97, P = 0.0218). Curve fitting revealed a nonlinear relationship between BMI and 28-day mortality. The Kaplan-Meier survival analysis highlighted variations in survival rates across the five groups (P = 0.0123), with underweight patients exhibiting poorer survival outcomes.

Conclusion: In sepsis patients, a low BMI is related to higher 28-day mortality compared to those with a normal BMI. Conversely, patients with a BMI≥35 kg/m² have significantly reduced mortality risks.

查看原文本刊更多论文

败血症患者体重指数与 28 天死亡率之间的关系：回顾性队列研究

背景：败血症是一种严重的临床综合征，在重症监护病房（ICU）中发病率和死亡率都很高。体重指数（BMI）显示，重症监护病房收治的肥胖患者呈上升趋势。体重指数与败血症临床结果之间的关系仍存在很大争议：本研究使用的数据来自重症监护信息中心IV（MIMIC-IV）数据库。根据世界卫生组织（WHO）的体重指数分类，对重症监护病房入院 24 小时内提取的基线信息进行了分类。多变量 Cox 回归模型和曲线拟合评估了 BMI 与主要结果之间的独立相关性：研究共纳入了 7836 名患者，并根据体重指数分为五组。28 天总死亡率为 21.94%（1719/7836）。I级肥胖（17.14%）和II/III级肥胖（13.49%）患者多为年轻男性。与体重指数正常的患者（32.55%）相比，体重指数低的患者（5.79%）28 天内的死亡风险增加了 47%（HR 1.47，95% CI 1.16-1.85，P = 0.0013），而 II/III 级肥胖患者 28 天内的死亡率降低了 17%（HR 0.83，95% CI 0.71-0.97，P = 0.0218）。曲线拟合显示，体重指数与 28 天死亡率之间存在非线性关系。Kaplan-Meier生存分析显示，五组患者的生存率存在差异（P = 0.0123），体重过轻的患者生存率较低：结论：在败血症患者中，与体重指数正常的患者相比，体重指数低的患者 28 天死亡率较高。相反，体重指数≥35 kg/m2的患者的死亡风险明显降低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

American Surgeon 医学-外科

CiteScore

1.40

自引率

0.00%

发文量

623

期刊介绍： The American Surgeon is a monthly peer-reviewed publication published by the Southeastern Surgical Congress. Its area of concentration is clinical general surgery, as defined by the content areas of the American Board of Surgery: alimentary tract (including bariatric surgery), abdomen and its contents, breast, skin and soft tissue, endocrine system, solid organ transplantation, pediatric surgery, surgical critical care, surgical oncology (including head and neck surgery), trauma and emergency surgery, and vascular surgery.