Papadimitriou-Olivgeris Matthaios, Aretha Diamanto, Zotou Anastasia, Koutsileou Kyriaki, Zbouki Aikaterini, Lefkaditi Aikaterini, Sklavou Christina, Marangos Markos, Fligou Fotini
Division of Infectious Diseases, School of Medicine, University of Patras, Rion, 26504 Patras, Greece.
Department of Anaesthesiology and Intensive Care Medicine, School of Medicine, University of Patras, Rion, 26504 Patras, Greece.
Biomed Res Int. 2016;2016:5941279. doi: 10.1155/2016/5941279. Epub 2016 Sep 29.
The objective of this study was to assess the correlation between sepsis, obesity, and mortality of patients admitted to an Intensive Care Unit (ICU). Data of all patients admitted to the ICU of a tertiary hospital during a 28-month period were retrospectively analyzed and included in the study. Of 834 patients included, 163 (19.5%) were obese, while 25 (3.0%) were morbidly obese. Number of comorbidities ( < 0.001), bloodstream infection ( 0.033), and carbapenemase-producing colonization during ICU stay ( 0.005) were significantly associated with obesity, while nonobese patients suffered more frequently from spontaneous intracranial hemorrhage ( 0.038). Total ICU mortality was 22.5%. Increased mortality among obese ICU patients was observed. Sepsis was the main condition of admission for which obese patients had statistically lower survival than normal weight subjects (76.3% versus 43.7%; 0.001). Mortality of septic patients upon admission was independently associated with SOFA score upon ICU admission ( 0.003), obesity ( 0.014), pneumonia ( 0.038), and development of septic shock ( 0.015). Our study revealed that sepsis upon ICU admission is adversely influenced by obesity but further studies are needed in order to assess the role of obesity in sepsis outcome.
本研究的目的是评估入住重症监护病房（ICU）的患者败血症、肥胖与死亡率之间的相关性。对一家三级医院ICU在28个月期间收治的所有患者的数据进行回顾性分析，并纳入本研究。在纳入的834例患者中，163例（19.5%）为肥胖患者，25例（3.0%）为病态肥胖患者。合并症数量（<0.001）、血流感染（=0.033）以及ICU住院期间产碳青霉烯酶定植（=0.005）与肥胖显著相关，而非肥胖患者自发性颅内出血的发生率更高（=0.038）。ICU总死亡率为22.5%。观察到肥胖ICU患者的死亡率增加。败血症是肥胖患者入院的主要原因，肥胖患者的生存率在统计学上低于正常体重患者（76.3%对43.7%；=0.001）。脓毒症患者入院时的死亡率与ICU入院时的序贯器官衰竭评估（SOFA）评分（=0.003）、肥胖（=0.014）、肺炎（=0.038）以及感染性休克的发生（=0.015）独立相关。我们的研究表明，ICU入院时的败血症受到肥胖的不利影响，但需要进一步研究以评估肥胖在败血症转归中的作用。
