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The association between body-mass index and patient outcome in septic shock: a retrospective cohort study.
Wien Klin Wochenschr. 2010 Jan; 122(1-2):31-6.WK

Abstract

BACKGROUND

It is unknown whether body-mass index (BMI) and commonly defined BMI categories are associated with mortality in patients with septic shock.

METHODS

The database of a multidisciplinary intensive care unit (ICU) was retrospectively screened for adult patients with septic shock. BMI, demographic, clinical and laboratory variables together with outcome measures were collected in all patients. Subjects were categorized as follows: underweight, BMI < 18.5; normal weight, BMI 18.5-24.9; overweight, BMI 25-29.9; obesity, BMI >or= 30. Bivariate and multivariate logistic regression models were used to evaluate the association between BMI and outcome parameters.

RESULTS

In total, 301 patients with septic shock were identified. BMI was bivariately associated with ICU mortality (OR 0.91; 95% CI 0.86-0.98; P = 0.007). There was no significant association between BMI and ICU mortality in the multivariate model but an increasing BMI tended to be associated with lower ICU mortality (OR 0.93; 95% CI 0.86-1.01; P = 0.09). Although overweight (OR 0.43; 95% CI 0.19-0.98; P = 0.04) and obese (OR 0.28; 95% CI 0.08-0.93; P = 0.04) patients had an independently lower risk of ICU death than those with normal weight, there was no difference in the risk of ICU death between normal weight and underweight patients (P = 0.22). A high BMI was independently associated with a lower frequency of acute delirium (P = 0.04) and a lower need for ICU re-admission (P = 0.001) but with a higher rate of ICU-acquired urinary tract infections (P = 0.02).

CONCLUSIONS

BMI up to 50 does not appear to be associated with worse ICU and hospital mortality in patients with septic shock. In contrast, a high BMI may reduce the risk of death from septic shock.

Authors+Show Affiliations

Department of Anesthesiology and Critical Care Medicine, Krankenhaus der Barmherzigen Schwestern, Ried im Innkreis, Austria.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20177857

Citation

Wurzinger, Bettina, et al. "The Association Between Body-mass Index and Patient Outcome in Septic Shock: a Retrospective Cohort Study." Wiener Klinische Wochenschrift, vol. 122, no. 1-2, 2010, pp. 31-6.
Wurzinger B, Dünser MW, Wohlmuth C, et al. The association between body-mass index and patient outcome in septic shock: a retrospective cohort study. Wien Klin Wochenschr. 2010;122(1-2):31-6.
Wurzinger, B., Dünser, M. W., Wohlmuth, C., Deutinger, M. C., Ulmer, H., Torgersen, C., Schmittinger, C. A., Grander, W., & Hasibeder, W. R. (2010). The association between body-mass index and patient outcome in septic shock: a retrospective cohort study. Wiener Klinische Wochenschrift, 122(1-2), 31-6. https://doi.org/10.1007/s00508-009-1241-4
Wurzinger B, et al. The Association Between Body-mass Index and Patient Outcome in Septic Shock: a Retrospective Cohort Study. Wien Klin Wochenschr. 2010;122(1-2):31-6. PubMed PMID: 20177857.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association between body-mass index and patient outcome in septic shock: a retrospective cohort study. AU - Wurzinger,Bettina, AU - Dünser,Martin W, AU - Wohlmuth,Christoph, AU - Deutinger,Martina C, AU - Ulmer,Hanno, AU - Torgersen,Christian, AU - Schmittinger,Christian A, AU - Grander,Wilhelm, AU - Hasibeder,Walter R, PY - 2009/06/25/received PY - 2009/07/23/accepted PY - 2010/2/24/entrez PY - 2010/2/24/pubmed PY - 2010/5/25/medline SP - 31 EP - 6 JF - Wiener klinische Wochenschrift JO - Wien Klin Wochenschr VL - 122 IS - 1-2 N2 - BACKGROUND: It is unknown whether body-mass index (BMI) and commonly defined BMI categories are associated with mortality in patients with septic shock. METHODS: The database of a multidisciplinary intensive care unit (ICU) was retrospectively screened for adult patients with septic shock. BMI, demographic, clinical and laboratory variables together with outcome measures were collected in all patients. Subjects were categorized as follows: underweight, BMI < 18.5; normal weight, BMI 18.5-24.9; overweight, BMI 25-29.9; obesity, BMI >or= 30. Bivariate and multivariate logistic regression models were used to evaluate the association between BMI and outcome parameters. RESULTS: In total, 301 patients with septic shock were identified. BMI was bivariately associated with ICU mortality (OR 0.91; 95% CI 0.86-0.98; P = 0.007). There was no significant association between BMI and ICU mortality in the multivariate model but an increasing BMI tended to be associated with lower ICU mortality (OR 0.93; 95% CI 0.86-1.01; P = 0.09). Although overweight (OR 0.43; 95% CI 0.19-0.98; P = 0.04) and obese (OR 0.28; 95% CI 0.08-0.93; P = 0.04) patients had an independently lower risk of ICU death than those with normal weight, there was no difference in the risk of ICU death between normal weight and underweight patients (P = 0.22). A high BMI was independently associated with a lower frequency of acute delirium (P = 0.04) and a lower need for ICU re-admission (P = 0.001) but with a higher rate of ICU-acquired urinary tract infections (P = 0.02). CONCLUSIONS: BMI up to 50 does not appear to be associated with worse ICU and hospital mortality in patients with septic shock. In contrast, a high BMI may reduce the risk of death from septic shock. SN - 1613-7671 UR - https://www.unboundmedicine.com/medline/citation/20177857/The_association_between_body_mass_index_and_patient_outcome_in_septic_shock:_a_retrospective_cohort_study_ L2 - https://dx.doi.org/10.1007/s00508-009-1241-4 DB - PRIME DP - Unbound Medicine ER -