Intensive Care National Audit & Research Centre (ICNARC), Napier House, 24 High Holborn, London WC1V 6AZ, United Kingdom; Department of Clinical Medicine, Aalborg University and Aalborg University Hospital, Aalborg, Denmark; Department of Anaesthesia and Intensive Care, Aalborg University and Aalborg University Hospital, Aalborg, Denmark.
Intensive Care National Audit & Research Centre (ICNARC), Napier House, 24 High Holborn, London WC1V 6AZ, United Kingdom.
J Crit Care. 2018 Apr;44:196-202. doi: 10.1016/j.jcrc.2017.11.021. Epub 2017 Nov 15.
Studies have demonstrated an association between height and weight and mortality among patients in the Intensive Care Unit (ICU) and the optimal body mass index (BMI) might be well above the optimal values in the general population. Most of these studies have relied on estimated values, the validity of which is not known.
Admissions to adult general ICUs from 1 April 2009 to 31 March 2016 in the Case Mix Programme (CMP) Database were described by height and weight assessment methods (measured or estimated). A multilevel logistic regression model was built, which had acute hospital mortality as the outcome and included standard case mix adjustment, BMI, the assessment method and the interactions between BMI and assessment method.
There were 690,405 eligible admissions and most patients (59.7%) had estimates of height and/or weight recorded. Patients with both height and weight measured had lower severity and mortality. The association between BMI and mortality was reverse J-shaped with the lowest mortality at BMI 34.3kg/m2. Whether height and weight were measured or estimated did not influence the association between BMI and mortality.
For epidemiological comparisons of mortality among critically ill adults, estimated values of height and weight appear valid.
研究表明，重症监护病房（ICU）患者的身高和体重与死亡率之间存在关联，而最佳体重指数（BMI）可能远高于普通人群的最佳值。这些研究大多依赖于估计值，其有效性尚不清楚。
在病例组合计划（CMP）数据库中，描述了 2009 年 4 月 1 日至 2016 年 3 月 31 日期间成人普通 ICU 的入院情况，评估方法包括身高和体重测量（测量或估计）。建立了一个多水平逻辑回归模型，以急性医院死亡率为结果，包括标准病例组合调整、BMI、评估方法以及 BMI 和评估方法之间的相互作用。
共有 690405 例符合条件的入院患者，其中大多数患者（59.7%）记录了身高和/或体重的估计值。身高和体重均有测量的患者严重程度和死亡率较低。BMI 与死亡率之间呈反向 J 形关系，BMI 为 34.3kg/m2 时死亡率最低。身高和体重的测量或估计并不影响 BMI 与死亡率之间的关联。
对于危重症成年人死亡率的流行病学比较，身高和体重的估计值似乎是有效的。
