Department of Anesthesiology, The First People's Hospital of Kunshan Affiliated with Jiangsu University, Kunshan, Jiangsu, People's Republic of China.
Department of Endocrinology, The First People's Hospital of Kunshan Affiliated with Jiangsu University, Kunshan, China.
BMJ Open. 2023 Feb 10;13(2):e066526. doi: 10.1136/bmjopen-2022-066526.
Sepsis is a major contributor of intensive care units (ICUs) patient mortality. Prior investigations claimed that obesity enhances overall survival (OS) of septic patients. However, the reported results were inconsistent. This study examined the association between obesity and the 1-year mortality of septic patients.
A retrospective cohort study.
The Medical Information Mart for Intensive Care III database.
3145 septic patients were separated into three distinct cohorts, based on their WHO body mass index (BMI) status.
Our primary endpoint was the 1-year mortality from the date of ICU hospitalization.
1334 (42.4%) died within 1 year. The 1-year mortality rate was low in obese patients (38.8%), compared with normal (46.9%) and overweight (42.1%) patients. Crude assessment revealed that obese patients experienced reduced 1-year mortality, relative to normal weight patients (HR 0.79, 95% CI 0.69 to 0.9, p<0.001). However, once adjusted for baseline variables and comorbidities, no correlation was found between obesity and the 1-year mortality (HR 0.93, 95% CI 0.81 to 1.06, p=0.28) of septic patients. There was an association among diabetic (HR 0.72, 95% CI 0.56 to 0.93, p=0.012) and hypertensive (HR 0.73, 95% CI 0.58 to 0.92, p=0.008) patients, and among males (HR 0.71, 95% CI 0.59 to 0.86, p<0.001), with obese individuals experiencing the lowest mortality rate. Given these evidences, the interactions between BMI and mortality in diabetic (p=0.031) and hypertensive (p=0.035) patients were significant.
In our study, obese diabetic and hypertensive patients associated to less sepsis-related mortality risk, compared with normal weight patients. Further researches were need to validated.
脓毒症是重症监护病房（ICU）患者死亡的主要原因。先前的研究声称肥胖症提高了脓毒症患者的总生存率（OS）。然而，报告的结果并不一致。本研究检查了肥胖症与脓毒症患者 1 年死亡率之间的关系。
回顾性队列研究。
医疗信息集市重症监护 III 数据库。
根据世界卫生组织（WHO）的体重指数（BMI）状态，将 3145 名脓毒症患者分为三个不同队列。
我们的主要终点是从 ICU 住院之日起 1 年内的死亡率。
1334 名（42.4%）患者在 1 年内死亡。肥胖患者的 1 年死亡率较低（38.8%），与正常体重（46.9%）和超重（42.1%）患者相比。初步评估显示，肥胖患者的 1 年死亡率相对正常体重患者有所降低（HR0.79，95%CI0.69 至 0.9，p<0.001）。然而，一旦调整了基线变量和合并症，肥胖症与脓毒症患者 1 年死亡率（HR0.93，95%CI0.81 至 1.06，p=0.28）之间没有相关性。在糖尿病患者（HR0.72，95%CI0.56 至 0.93，p=0.012）和高血压患者（HR0.73，95%CI0.58 至 0.92，p=0.008）以及男性患者（HR0.71，95%CI0.59 至 0.86，p<0.001）中存在关联，肥胖患者的死亡率最低。鉴于这些证据，BMI 与糖尿病（p=0.031）和高血压（p=0.035）患者死亡率之间的相互作用具有统计学意义。
在我们的研究中，与正常体重患者相比，肥胖的糖尿病和高血压患者与较低的脓毒症相关死亡率风险相关。需要进一步的研究来验证。
