Department of Respiratory Medicine, Zhuji Affiliated Hospital of Wenzhou Medical University, No. 9 Jianmin Road Taozhu Street, 311800, Zhuji, China.
Med Klin Intensivmed Notfmed. 2024 Apr;119(3):220-226. doi: 10.1007/s00063-023-01042-7. Epub 2023 Aug 16.
To evaluate the link between obesity and mortality in patients with acute respiratory distress syndrome (ARDS).
We performed a retrospective cohort study of a large clinical database. A Cox proportional hazards regression model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for the relationship between body mass index (BMI) and mortality. The primary endpoint was 30-day death rate and the secondary endpoints were 90-day and 1‑year mortality.
Overall, 418 patients with ARDS were enrolled in the study, including 185 women and 233 men (age: 70.7 ± 44.1 years; BMI: 28.7 ± 8.1 kg/m). Compared with patients with normal weight, obese patients were younger (60.1 ± 13.7, p = 0.003) and a higher percentage of these patients were women (51.3% vs. 49.0%, p = 0.001). The HRs (95% CI) of 30-day mortality in the underweight, overweight, and obese populations were 1.82 (0.85, 3.90), 0.59 (0.29, 1.20), and 3.85 (1.73, 8.57), respectively, after adjustment for other confounding factors. A similar pattern was also seen for death after 90 days and after 1 year. A U-shaped association between BMI and 30-day mortality was discovered by curve fitting.
Obesity had a significant impact on the short- and long-term mortality in patients with ARDS. There was a U-shaped relationship between BMI and mortality, while a higher BMI was associated with an increased risk of death in patients with ARDS.
评估肥胖与急性呼吸窘迫综合征（ARDS）患者死亡率之间的关系。
我们对一个大型临床数据库进行了回顾性队列研究。使用 Cox 比例风险回归模型计算体质指数（BMI）与死亡率之间的关系的风险比（HR）和 95%置信区间（CI）。主要终点为 30 天死亡率，次要终点为 90 天和 1 年死亡率。
共有 418 例 ARDS 患者纳入本研究，包括 185 例女性和 233 例男性（年龄：70.7±44.1 岁；BMI：28.7±8.1 kg/m²）。与体重正常的患者相比，肥胖患者年龄更小（60.1±13.7，p=0.003），且女性比例更高（51.3%比 49.0%，p=0.001）。在调整其他混杂因素后，消瘦、超重和肥胖人群 30 天死亡率的 HR（95%CI）分别为 1.82（0.85，3.90）、0.59（0.29，1.20）和 3.85（1.73，8.57）。对于 90 天后和 1 年后的死亡情况，也出现了类似的模式。通过曲线拟合发现 BMI 与 30 天死亡率之间存在 U 形关联。
肥胖对 ARDS 患者的短期和长期死亡率有显著影响。BMI 与死亡率之间存在 U 形关系，而 ARDS 患者的 BMI 越高，死亡风险越高。
