Obesity is associated with increased morbidity but not mortality in critically ill patients
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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.
Planned substudy from the SOAP database.
One hundred and ninety-eight ICUs in 24 European countries.
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.
BMI did not have a significant impact on mortality in this mixed population of ICU patients.
KeywordsBody mass index Multicentre Outcome Intensive care Nosocomial infection
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.
- 9.Grady KL, White-Williams C, Naftel D, Costanzo MR, Pitts D, Rayburn B, VanBakel A, Jaski B, Bourge R, Kirklin J (1999) Are preoperative obesity and cachexia risk factors for postheart transplant morbidity and mortality: a multi-institutional study of preoperative weight–height indices. Cardiac transplant research database (CTRD) Group. J Heart Lung Transplant 18:750–763PubMedCrossRefGoogle Scholar
- 33.Sakr Y, de Pont AC, Lovstad RZ, Reinhart K, Vincent JL (2006) Does obesity in the ICU influence outcome? Intensive Care Med 32:58 (abstract)Google Scholar
- 36.(1992) American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20:864–874Google Scholar
- 37.Vincent JL, de Mendonça A, Cantraine F, Moreno R, Takala J, Suter P, Sprung C, Colardyn FC, Blecher S (1998) Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicentric, prospective study. Crit Care Med 26:1793–1800PubMedGoogle Scholar
- 38.National Institutes of Health NHLBI Obesity Education Initiative Expert Panel (1998) Clinical guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: the Evidence Report. US Department of Health and Human Services, WashingtonGoogle Scholar
- 40.Galanos AN, Pieper CF, Kussin PS, Winchell MT, Fulkerson WJ, Harrell FE Jr, Teno JM, Layde P, Connors AF Jr, Phillips RS, Wenger NS (1997) Relationship of body mass index to subsequent mortality among seriously ill hospitalized patients. SUPPORT investigators. The study to understand prognoses and preferences for outcome and risks of treatments. Crit Care Med 25:1962–1968PubMedCrossRefGoogle Scholar