Bai Le, Huang Jingyi, Wang Dan, Zhu Dongwei, Zhao Qi, Li Tingyuan, Zhou Xianmei, Xu Yong
Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, People's Republic of China.
Baoshan Branch, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.
J Intensive Care. 2023 Jul 3;11(1):27. doi: 10.1186/s40560-023-00677-0.
The effects of body mass index (BMI) on mortality of sepsis remain unknown, since previous meta-analyses have reported conflicting results. Several observational studies published recently have provided new evidence. Thus, we performed this updated meta-analysis.
PubMed, Embase, Web of Science, and Cochran Library were searched for articles published before February 10, 2023. Observational studies that assessed the association of BMIs with mortality of sepsis patients aged > 18 years were selected. We excluded studies of which data were unavailable for quantitative synthesis. Odds ratios (OR) with 95% confidence interval (CI) were the effect measure, which were combined using fixed-effect or random-effect models. The Newcastle-Ottawa Scale was applied for quality assessment. Subgroups analyses were conducted according to potential confounders.
Fifteen studies (105,159 patients) were included in the overall analysis, which indicated that overweight and obese BMIs were associated with lower mortality (OR: 0.79, 95% CI 0.70-0.88 and OR: 0.74, 95% CI 0.67-0.82, respectively). The association was not significant in patients aged ≤ 50 years (OR: 0.89, 95% CI 0.68-1.14 and OR: 0.77, 95% CI 0.50-1.18, respectively). In addition, the relationship between morbidly obesity and mortality was not significant (OR: 0.91, 95% CI 0.62-1.32).
Overweight and obese BMIs (25.0-39.9 kg/m) are associated with reduced mortality of patients with sepsis or septic shock, although such survival advantage was not found in all crowds. Trial registration The protocol of this study was registered in PROSPERO (registration number CRD42023399559).
由于之前的荟萃分析结果相互矛盾，体重指数（BMI）对脓毒症死亡率的影响尚不清楚。最近发表的几项观察性研究提供了新的证据。因此，我们进行了这项更新的荟萃分析。
检索了PubMed、Embase、Web of Science和Cochrane图书馆中截至2023年2月10日发表的文章。选择评估BMI与18岁以上脓毒症患者死亡率之间关联的观察性研究。我们排除了无法获取数据进行定量综合分析的研究。以95%置信区间（CI）的比值比（OR）作为效应量，采用固定效应或随机效应模型进行合并。应用纽卡斯尔-渥太华量表进行质量评估。根据潜在混杂因素进行亚组分析。
总共纳入15项研究（105159例患者），分析表明超重和肥胖的BMI与较低的死亡率相关（OR分别为0.79，95%CI 0.70 - 0.88和OR为0.74，95%CI 0.67 - 0.82）。在年龄≤50岁的患者中，这种关联不显著（OR分别为0.89，95%CI 0.68 - 1.14和OR为0.77，95%CI 0.50 - 1.18）。此外，病态肥胖与死亡率之间的关系不显著（OR为0.91，95%CI 0.62 - 1.32）。
超重和肥胖的BMI（25.0 - 39.9kg/m²）与脓毒症或脓毒性休克患者死亡率降低相关，尽管并非在所有人群中都发现这种生存优势。试验注册 本研究方案已在PROSPERO注册（注册号CRD42023399559）。
