Ayoup Abdurahman Najy, Tlayjeh Haytham, Jose Jesna, Alenezi Farhan Zayed, Sadat Musharaf, Bin Humaid Felwa, Al-Hameed Fahad, Al Khatib Kasim, Omer Shawgi Osman Mohammed, AlHumedi Haifa, Alrawy Alanazi Samiyah, Albaalharith Nahlah Awadh, Arabi Yaseen M
Intensive Care Department, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Saudi Arabia.
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia.
J Int Med Res. 2025 Sep;53(9):3000605251370302. doi: 10.1177/03000605251370302. Epub 2025 Sep 8.
ObjectivesTo assess the association of obesity with outcomes among patients with severe acute respiratory infection.MethodsThis is a retrospective cohort study of patients with severe acute respiratory infection admitted to the intensive care units in four referral hospitals in Saudi Arabia between September 2012 and June 2018. Patients were classified into two groups: overweight-obese patients (body mass index ≥25 kg/m) and normal-weight patients (body mass index between 18.5 and 24.9 kg/m). All underweight patients with a body mass index <18.5 kg/m were excluded from the study.ResultsOf the 421 patients, 294 were in the overweight-obese group and 127 were in the normal-weight group. There was no difference in crude 90-day mortality between the two groups. However, multivariate regression analysis showed that overweight-obese patients had lower 90-day mortality than normal-weight patients (odds ratio, 0.71; 95% confidence interval, 0.60-0.85; = 0.0002). Interestingly, increasing age was associated with a significant increase in mortality (odds ratio, 1.03; 95% confidence interval, 1.02-1.03; < 0.0001). Moreover, the Sequential Organ Failure Assessment score was associated with a significant increase in mortality (odds ratio, 1.21; 95% confidence interval, 1.15-1.26; < 0.0001).DiscussionOur study showed lower mortality among overweight-obese patients, supporting the phenomenon of obesity paradox.ConclusionOverweight and obesity were common among patients with severe acute respiratory infection. Our study demonstrates that the obesity paradox exists among patients with severe acute respiratory infection.
目的
评估肥胖与重症急性呼吸道感染患者预后之间的关联。
方法
这是一项对2012年9月至2018年6月期间沙特阿拉伯四家转诊医院重症监护病房收治的重症急性呼吸道感染患者进行的回顾性队列研究。患者分为两组：超重肥胖患者（体重指数≥25 kg/m）和正常体重患者（体重指数在18.5至24.9 kg/m之间）。所有体重指数<18.5 kg/m的体重过轻患者被排除在研究之外。
结果
421例患者中，超重肥胖组294例，正常体重组127例。两组的90天粗死亡率无差异。然而，多因素回归分析显示，超重肥胖患者的90天死亡率低于正常体重患者（比值比，0.71；95%置信区间，0.60 - 0.85；P = 0.0002）。有趣的是，年龄增加与死亡率显著增加相关（比值比，1.03；95%置信区间，1.02 - 1.03；P < 0.0001）。此外，序贯器官衰竭评估评分与死亡率显著增加相关（比值比，1.21；95%置信区间，1.15 - 1.26；P < 0.0001）。
讨论
我们的研究显示超重肥胖患者的死亡率较低，支持肥胖悖论现象。
结论
超重和肥胖在重症急性呼吸道感染患者中很常见。我们的研究表明重症急性呼吸道感染患者中存在肥胖悖论。
