• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

体重指数对老年脓毒症患者临床结局的影响：一项基于MIMIC IV数据库的回顾性研究。

The impact of body mass index on clinical outcomes in elderly sepsis patients: a retrospective study based on the MIMIC IV database.

作者信息

Fan Zhao-Kun, Yi Ru-Qin, Feng Wen, Li Cheng-En, Chen Wei, Zhang Zhi-Rong, Shen Ying-Ying

机构信息

The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310006, China.

Department of Intensive Care Unit, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, 310006, China.

出版信息

Aging Clin Exp Res. 2025 Jul 9;37(1):211. doi: 10.1007/s40520-025-03115-3.

DOI:10.1007/s40520-025-03115-3
PMID:40632354
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12241261/
Abstract

BACKGROUND

Sepsis is a major health threat in the elderly, with high morbidity and mortality. Emerging evidence suggests an "obesity paradox," where higher body mass index (BMI) may improve survival. However, the association between BMI and outcomes in elderly sepsis patients remains unclear.

METHODS

Using data from the MIMIC-IV v3.1 database (2008-2022), we conducted a retrospective cohort study of sepsis patients aged ≥ 60 years. After 1:1 propensity score matching based on demographics and severity scores, 9,602 patients (4,801 obese; 4,801 non-obese) were included. Kaplan-Meier curves, Cox regression, and restricted cubic spline (RCS) analyses were used to evaluate mortality at 28, 90, and 180 days. Secondary outcomes included hospital and ICU length of stay (LOS), and mechanical ventilation (MV) duration.

RESULTS

Obese patients had significantly lower mortality at 28 (HR = 0.83), 90 (HR = 0.79), and 180 days (HR = 0.76; all p < 0.001). RCS showed an L-shaped curve, with lowest mortality at BMI ≈ 36 kg/m². However, obesity was associated with longer hospital (p = 0.021), ICU stays (p = 0.0005), and MV duration (p = 0.0002). Subgroup analysis confirmed that overweight and moderately obese patients had the best survival, while underweight patients fared worst.

CONCLUSION

Obesity is linked to improved survival in elderly sepsis patients, supporting the obesity paradox. Yet, it also entails greater healthcare utilization. Moderate obesity (BMI 30-35 kg/m²) appears most beneficial. Further studies are needed to clarify mechanisms and guide personalized sepsis care.

摘要

背景

脓毒症是老年人面临的重大健康威胁，发病率和死亡率都很高。新出现的证据表明存在“肥胖悖论”，即较高的体重指数（BMI）可能会提高生存率。然而，BMI与老年脓毒症患者预后之间的关联仍不明确。

方法

利用多中心重症医学信息数据库（MIMIC-IV）v3.1数据库（2008 - 2022年）的数据，我们对年龄≥60岁的脓毒症患者进行了一项回顾性队列研究。在根据人口统计学和严重程度评分进行1:1倾向评分匹配后，纳入了9602例患者（4801例肥胖患者；4801例非肥胖患者）。采用Kaplan-Meier曲线、Cox回归和限制性立方样条（RCS）分析来评估28天、90天和180天的时候的死亡率。次要结局包括住院时间和重症监护病房（ICU）住院时间以及机械通气（MV）持续时间。

结果

肥胖患者在28天（风险比[HR]=0.83）、90天（HR=0.79）和180天（HR=0.76；所有p<0.001）时的死亡率显著较低。RCS显示为L形曲线，BMI约为36kg/m²时死亡率最低。然而，肥胖与更长的住院时间（p=0.021）、ICU住院时间（p=0.0005）和MV持续时间（p=0.0002）相关。亚组分析证实，超重和中度肥胖患者的生存率最佳，而体重过轻的患者预后最差。

结论

肥胖与老年脓毒症患者生存率的提高有关，支持肥胖悖论。然而，它也需要更多的医疗资源利用。中度肥胖（BMI 30 - 35kg/m²）似乎最有益。需要进一步研究来阐明其机制并指导个性化的脓毒症治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/1c4417b1711d/40520_2025_3115_Fig11_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/9fafcc80c749/40520_2025_3115_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/06abdb701bfe/40520_2025_3115_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/f3adc40e0d38/40520_2025_3115_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/013a04e670fa/40520_2025_3115_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/ba73daf78dcc/40520_2025_3115_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/8ea78f7fbb10/40520_2025_3115_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/919b8669c4c7/40520_2025_3115_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/1a667c8cb5ac/40520_2025_3115_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/e2f4638930f4/40520_2025_3115_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/d66b113d6faa/40520_2025_3115_Fig10_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/1c4417b1711d/40520_2025_3115_Fig11_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/9fafcc80c749/40520_2025_3115_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/06abdb701bfe/40520_2025_3115_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/f3adc40e0d38/40520_2025_3115_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/013a04e670fa/40520_2025_3115_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/ba73daf78dcc/40520_2025_3115_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/8ea78f7fbb10/40520_2025_3115_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/919b8669c4c7/40520_2025_3115_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/1a667c8cb5ac/40520_2025_3115_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/e2f4638930f4/40520_2025_3115_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/d66b113d6faa/40520_2025_3115_Fig10_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6d/12241261/1c4417b1711d/40520_2025_3115_Fig11_HTML.jpg

相似文献

1
The impact of body mass index on clinical outcomes in elderly sepsis patients: a retrospective study based on the MIMIC IV database.体重指数对老年脓毒症患者临床结局的影响：一项基于MIMIC IV数据库的回顾性研究。
Aging Clin Exp Res. 2025 Jul 9;37(1):211. doi: 10.1007/s40520-025-03115-3.
2
L-shape association between serum chloride and 365-day mortality in critically ill patients with sepsis based on the MIMIC-IV database.基于MIMIC-IV数据库的脓毒症重症患者血清氯与365天死亡率的L型关联
Sci Rep. 2025 Jul 1;15(1):20391. doi: 10.1038/s41598-025-08630-x.
3
Mortality and amputation outcomes of infrainguinal bypass versus endovascular therapy based on body mass index.基于体重指数的股腘动脉旁路移植术与血管腔内治疗的死亡率和截肢结局
J Vasc Surg. 2025 Jul;82(1):193-204. doi: 10.1016/j.jvs.2025.02.013. Epub 2025 Feb 19.
4
Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years.6至11岁超重或肥胖儿童治疗中的饮食、身体活动及行为干预措施
Cochrane Database Syst Rev. 2017 Jun 22;6(6):CD012651. doi: 10.1002/14651858.CD012651.
5
Impact of left ventricular stroke work index on 30-day mortality in sepsis: a retrospective analysis based on the MIMIC-III database.左心室每搏功指数对脓毒症30天死亡率的影响：基于MIMIC-III数据库的回顾性分析
BMC Infect Dis. 2025 Mar 10;25(1):334. doi: 10.1186/s12879-025-10723-x.
6
Statin use during intensive care unit stay is associated with improved clinical outcomes in critically ill patients with sepsis: a cohort study.一项队列研究表明，在重症监护病房住院期间使用他汀类药物与脓毒症重症患者临床预后改善相关。
Front Immunol. 2025 Jun 6;16:1537172. doi: 10.3389/fimmu.2025.1537172. eCollection 2025.
7
Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis.系统性药理学治疗慢性斑块状银屑病：网络荟萃分析。
Cochrane Database Syst Rev. 2021 Apr 19;4(4):CD011535. doi: 10.1002/14651858.CD011535.pub4.
8
Exercise rehabilitation following intensive care unit discharge for recovery from critical illness.重症监护病房出院后进行运动康复以促进危重症恢复。
Cochrane Database Syst Rev. 2015 Jun 22;2015(6):CD008632. doi: 10.1002/14651858.CD008632.pub2.
9
Metformin for women who are overweight or obese during pregnancy for improving maternal and infant outcomes.孕期超重或肥胖女性使用二甲双胍以改善母婴结局。
Cochrane Database Syst Rev. 2018 Jul 24;7(7):CD010564. doi: 10.1002/14651858.CD010564.pub2.
10
The role of increased body mass index in outcomes of sepsis: a systematic review and meta-analysis.体重指数增加在脓毒症结局中的作用：一项系统评价与荟萃分析
BMC Anesthesiol. 2017 Aug 31;17(1):118. doi: 10.1186/s12871-017-0405-4.

本文引用的文献

1
The obesity paradox in younger adult patients with sepsis: analysis of the MIMIC-IV database.脓毒症年轻成年患者的肥胖悖论：MIMIC-IV 数据库分析。
Int J Obes (Lond). 2024 Sep;48(9):1223-1230. doi: 10.1038/s41366-024-01523-5. Epub 2024 Apr 26.
2
Sepsis and obesity: a scoping review of diet-induced obesity murine models.脓毒症与肥胖：饮食诱导肥胖小鼠模型的综述
Intensive Care Med Exp. 2024 Feb 23;12(1):15. doi: 10.1186/s40635-024-00603-0.
3
Surviving Sepsis Campaign.拯救脓毒症运动
Crit Care Med. 2023 Apr 1;51(4):431-444. doi: 10.1097/CCM.0000000000005804. Epub 2023 Mar 18.
4
Obesity Paradox and Functional Outcomes in Sepsis: A Multicenter Prospective Study.肥胖悖论与脓毒症的功能结局：一项多中心前瞻性研究。
Crit Care Med. 2023 Jun 1;51(6):742-752. doi: 10.1097/CCM.0000000000005801. Epub 2023 Feb 9.
5
MIMIC-IV, a freely accessible electronic health record dataset.MIMIC-IV，一个可自由访问的电子健康记录数据集。
Sci Data. 2023 Jan 3;10(1):1. doi: 10.1038/s41597-022-01899-x.
6
Obesity in the critically ill: a narrative review.危重症患者中的肥胖：一篇叙述性综述。
Intensive Care Med. 2019 Jun;45(6):757-769. doi: 10.1007/s00134-019-05594-1. Epub 2019 Mar 19.
7
Does Obesity Protect Against Death in Sepsis? A Retrospective Cohort Study of 55,038 Adult Patients.肥胖是否能预防脓毒症患者死亡？一项对 55038 例成年患者的回顾性队列研究。
Crit Care Med. 2019 May;47(5):643-650. doi: 10.1097/CCM.0000000000003692.
8
Adipokines in critical illness: A review of the evidence and knowledge gaps.危重病中的脂肪因子：证据和知识缺口的综述。
Biomed Pharmacother. 2018 Dec;108:1739-1750. doi: 10.1016/j.biopha.2018.09.165. Epub 2018 Oct 12.
9
The effect of obesity on lung function.肥胖对肺功能的影响。
Expert Rev Respir Med. 2018 Sep;12(9):755-767. doi: 10.1080/17476348.2018.1506331. Epub 2018 Aug 14.
10
An Overview and Update on Obesity and the Obesity Paradox in Cardiovascular Diseases.肥胖与心血管疾病中肥胖悖论的概述及最新进展
Prog Cardiovasc Dis. 2018 Jul-Aug;61(2):142-150. doi: 10.1016/j.pcad.2018.07.003. Epub 2018 Jul 5.