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Intensive Care Medicine

, Volume 34, Issue 11, pp 1999–2009 | Cite as

Obesity is associated with increased morbidity but not mortality in critically ill patients

  • Yasser Sakr
  • Christian Madl
  • Daniela Filipescu
  • Rui Moreno
  • Johan Groeneveld
  • Antonio Artigas
  • Konrad Reinhart
  • Jean-Louis Vincent
Original

Abstract

Objective

To investigate the possible impact of obesity on morbidity and mortality in intensive care unit (ICU) patients included in the European observational sepsis occurrence in acutely ill patients (SOAP) study.

Design

Planned substudy from the SOAP database.

Setting

One hundred and ninety-eight ICUs in 24 European countries.

Patients

All patients admitted to one of the participating ICUs. Patients were classified, according to their body mass index (BMI), as underweight (<18.5 kg/m2), normal weight (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), obese (30–39.9 kg/m2), and very obese (≥40 kg/m2).

Measurements and results

The BMI was available in 2,878 (91%) of the 3,147 patients included in the SOAP study; 120 patients (4.2%) were underweight, 1,206 (41.9%) had a normal BMI, 1,047 (36.4%) were overweight, 424 (14.7%) were obese, and 81 (2.8%) were very obese. Obese and very obese patients more frequently developed ICU-acquired infections than patients in lower BMI categories. Very obese patients showed a trend towards longer ICU [median (IQ): 4.1 (1.8–12.1) vs. 3.1 (1.7–7.2) days, P = 0.056) and hospital lengths of stay [14.3 (8.4–27.4) vs. 12.3 (5.1–24.4), days P = 0.077] compared to those with a normal BMI. However, there were no significant differences among the groups in ICU or hospital mortality rates. In a multivariate Cox regression analysis, none of the BMI categories was associated with an increased risk of 60-day in-hospital death.

Conclusion

BMI did not have a significant impact on mortality in this mixed population of ICU patients.

Keywords

Body mass index Multicentre Outcome Intensive care Nosocomial infection 

Notes

Acknowledgments

The SOAP study was supported by an unlimited grant from Abbott, Baxter, Eli Lilly, GlaxoSmithKline, and NovoNordisk. These companies had no involvement at any stage of the study design, in the collection and analysis of data, in writing the manuscript, or in the decision to submit for publication.

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Yasser Sakr
    • 1
  • Christian Madl
    • 2
  • Daniela Filipescu
    • 3
  • Rui Moreno
    • 4
  • Johan Groeneveld
    • 5
  • Antonio Artigas
    • 6
  • Konrad Reinhart
    • 1
  • Jean-Louis Vincent
    • 7
  1. 1.Department of Anaesthesiology and Intensive CareFriedrich-Schiller-University JenaJenaGermany
  2. 2.Intensive Care Unit 13H1, Department of Internal Medicine IVMedical University of ViennaViennaAustria
  3. 3.Department of Anesthesiology and Cardiac Intensive CareInstitute of Cardiovascular DiseasesBucharestRomania
  4. 4.Department of Intensive CareHospital de St Antonio dos CapuchosLisbonPortugal
  5. 5.Department of Intensive CareVU University Medical CenterAmsterdamThe Netherlands
  6. 6.Department of Intensive CareSabadell HospitalSabadellSpain
  7. 7.Department of Intensive Care, Hôpital ErasmeUniversité libre de BruxellesBrusselsBelgium

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