scholarly journals Association between body mass index and short-term mortality in patients with intra-abdominal infections: a retrospective, single-centre cohort study using the Medical Information Mart for Intensive Care database

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046623
Author(s):  
Qinglin Li ◽  
Yingmu Tong ◽  
Sinan Liu ◽  
Kaibo Yang ◽  
Chang Liu ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cohort Study ◽  
Intensive Care ◽  
Body Mass ◽  
Medical Information ◽  
Cox Regression ◽  
Obese Patients ◽  
Short Term ◽  
Short Term Mortality ◽  
Mimic Iii

ObjectivesThis study aimed to determine the relationship between the body mass index (BMI) and short-term mortality of patients with intra-abdominal infection (IAI) using the Medical Information Mart for Intensive Care (MIMIC-III) database.DesignRetrospective cohort study.SettingAdult intensive care units (ICUs) at a tertiary hospital in the USA .ParticipantsAdult IAI ICU patients from 2001 to 2012 in the MIMIC-III database.InterventionsIn univariate analysis, we compared the differences in the characteristics of patients in each BMI group. Cox regression models were used to evaluate the relationships between BMI and short-term prognosis.Primary and secondary outcome measures90-day survival.ResultsIn total, 1161 patients with IAI were included. There were 399 (34.4%) patients with a normal BMI (<25 kg/m2), 357 (30.8%) overweight patients (25–30 kg/m2) and 405 (34.9%) obese patients (>30 kg/m2) who tended to be younger (p<0.001) and had higher Sequential Organ Failure Assessment scores (p<0.05). The mortality of obese patients at 90 days was lower than that of patients with a normal BMI (20.74% vs 23.25%, p<0.05), but their length of stay in the ICU was higher (4.9 days vs 3.6 days, p<0.001); however, their rate of mechanical ventilation utilisation was higher (61.48% vs 56.86%, p<0.05). In the Cox regression model, we also confirmed that BMI was a protective factor in patients with IAIs, and the adjusted mortality rate of patients with a higher BMI was 0.97 times lower than that of patients with a lower BMI (p<0.001, HR=0.97, 95% CI 0.96 to 0.99).ConclusionsIAI patients with an overweight or obese status might have lower 90-day mortality than patients with a normal BMI.

scholarly journals Abdominal Obesity and Short-term Mortality in Critically Ill Patients with Sepsis: A Retrospective Cohort Study Based on the MIMIC-IV Database

2021 ◽  
Author(s):  
Zhou Lv ◽  
Minglu Gu ◽  
Miao Zhou ◽  
Yanfei Mao ◽  
Lai Jiang
Keyword(s):  
Metabolic Syndrome ◽  
Cohort Study ◽  
Intensive Care ◽  
Abdominal Obesity ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Obese Patients ◽  
Short Term ◽  
Icu Admission ◽  
Short Term Mortality

Abstract Purpose: Multiple studies have demonstrated an obesity paradox such that obese septic patients have a lower mortality rate and a relatively favorable prognosis. However, less is known on the association between abdominal obesity and short-term mortality in patients with sepsis. We conducted this study to determine whether the obesity-related survival benefit remains among abdominal obese patients.Methods: A retrospective cohort study was conducted using data derived from the Medical Information Mart for Intensive Care IV database. Septic patients (≥18 years) with or without abdominal obesity of first intensive care units (ICU) admission in the database were enrolled. The primary outcome was mortality within 28 days of ICU admission and multivariable logistic regression analyses were employed to assess any association between abdominal obesity and the outcome variable.Results: A total of 21534 patients were enrolled finally, the crude 28-day mortality benefit after ICU admission was not observed in patients with abdominal obesity (15.8% vs. 15.3%, p=0.32). In the extended multivariable logistic models, the odds ratio (OR) of abdominal obesity was significantly inversed after incorporating metabolic variables into the logistic model (OR range 1.094-2.872, p = 0.02). The subgroup analysis showed interaction effects in impaired fasting blood glucose/diabetes and metabolic syndrome subgroups (P = 0.001 and <0.001, respectively). In the subgroups of blood pressure, high-density lipoprotein cholesterol, and triglyceride level, no interaction was detected in the association between abdominal obesity and mortality. After propensity score matching, 6523 pairs of patients were selected. The mortality significantly higher in the abdominal obesity group (17.0% vs. 14.8%, p = 0.015). Notably, the non-abdominal obese patients were weaned off vasopressors and mechanical ventilation more quickly than those in the abdominal obesity group (vasopressor‑free days on day 28 of 27.0 vs. 26.8, p < 0.001; ventilation-free days on day 28 of 26.7 vs. 25.6, p < 0.001).Conclusion: Abdominal obesity was associated with increased risk of adjusted sepsis-related mortality within 28 days after ICU admission and was partially mediated through metabolic syndrome components.

scholarly journals Body Mass Index and Mortality in Korean Intensive Care Units: A Prospective Multicenter Cohort Study

PLoS ONE ◽  
2014 ◽  
Vol 9 (4) ◽  
pp. e90039 ◽  
Author(s):  
So Yeon Lim ◽  
Won-Il Choi ◽  
Kyeongman Jeon ◽  
Eliseo Guallar ◽  
Younsuck Koh ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cohort Study ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Body Mass ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort

Body mass index linked to short-term and long-term all-cause mortality in patients with acute myocardial infarction

2021 ◽  
pp. postgradmedj-2020-139677
Author(s):  
Rui Yang ◽  
Wen Ma ◽  
Zi-Chen Wang ◽  
Tao Huang ◽  
Feng-Shuo Xu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Body Mass Index ◽  
Intensive Care ◽  
Body Mass ◽  
Normal Weight ◽  
Short Term ◽  
Icu Patients ◽  
Long Term Mortality

Purposes of studyThis study aimed to elucidate the relationship between obesity and short-term and long-term mortality in patients with acute myocardial infarction (AMI) by analysing the body mass index (BMI).Study designA retrospective cohort study was performed on adult intensive care unit (ICU) patients with AMI in the Medical Information Mart for Intensive Care III database. The WHO BMI classification was used in the study. The Kaplan-Meier curve was used to show the likelihood of survival in patients with AMI. The relationships of the BMI classification with short-term and long-term mortality were assessed using Cox proportional hazard regression models.ResultsThis study included 1295 ICU patients with AMI, who were divided into four groups according to the WHO BMI classification. Our results suggest that obese patients with AMI tended to be younger (p<0.001), be men (p=0.001) and have higher blood glucose and creatine kinase (p<0.001) compared with normal weight patients. In the adjusted model, compared with normal weight AMI patients, those who were overweight and obese had lower ICU risks of death HR=0.64 (95% CI 0.46 to 0.89) and 0.55 (0.38 to 0.78), respectively, inhospital risks of death (0.77 (0.56 to 1.09) and 0.61 (0.43 to 0.87)) and long-term risks of death (0.78 0.64 to 0.94) and 0.72 (0.59 to 0.89). On the other hand, underweight patients had higher risks of short-term(ICU or inhospital mortality) and long-term mortality compared with normal weight patients (HR=1.39 (95% CI 0.58 to 3.30), 1.46 (0.62 to 3.42) and 1.99 (1.15 to 3.44), respectively).ConclusionsOverweight and obesity were protective factors for the short-term and long-term risks of death in patients with AMI.

scholarly journals Laparoscopic Sleeve Gastrectomy for Mildly Obese Patients (Body Mass Index of 30 <35 kg/m2): Operative Outcome and Short-Term Results

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Roger Noun ◽  
Ghassan Chakhtoura ◽  
Marwan Nasr ◽  
Judith Skaff ◽  
Naîm Choucair ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Body Mass ◽  
Operative Time ◽  
Excess Weight ◽  
Obese Patients ◽  
Short Term ◽  
Preoperative Body Mass Index ◽  
Mild Obesity

Background. Data concerning laparoscopic sleeve gastrectomy (LSG) in mild obesity are under investigation.Aim/Objective. May 2010 to May 2012, 122 consecutive patients with preoperative body mass index (BMI) of33±2.5 kg/m2(range 30–34.9) undergoing LSG were studied. Mean age was33±10years (range 15–60), and 105 (86%) were women. Mean preoperative weight was91±9.7 kg (range 66–121), and preoperative excess weight was30±6.7 kg (range 19–43). Comorbidities were detected in 44 (36%) patients.Results. Mean operative time was58±15 min (range 40–95), and postoperative stay was1.8±0.19days (range 1.5–3). There were no admissions to intensive care unit and no deaths within 30 days of surgery. The rates of leaks and strictures were 0%, and of hemorrhage 1.6%. At 12 months, BMI decreased to24.7±2, and the percentage of excess weight loss (% EWL) reached 76.5%. None of the patients had a BMI below 20 kg/m2. Comorbidities resolved in 70.5% or improved in 29.5%. Patient satisfaction scoring (1–5) at least 1 year after was4.6±0.8for body image and4.4±0.6for food tolerance.Conclusion. LSG for mildly obese patients has proved to be technically relatively easy, safe, and benefic in the short term.

scholarly journals Association between Body Mass Index and Short-Term Clinical Outcomes in Critically Ill Patients with Sepsis: A Real-World Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Shan Lin ◽  
Shanhui Ge ◽  
Wanmei He ◽  
Mian Zeng
Keyword(s):  
Body Mass Index ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Body Mass ◽  
Critically Ill Patients ◽  
Medical Information ◽  
Cox Regression ◽  
Normal Weight ◽  
Male Patients ◽  
Using Data

Background. Obesity is now recognized as one of the major public health threats, especially for patients with a critical illness. However, studies regarding whether and how body mass index (BMI) affects clinical outcomes in patients with sepsis are still scarce and controversial. The aim of our study was to determine the effect of BMI on critically ill patients with sepsis. Materials and Methods. We performed this study using data from the Medical Information Center for Intensive Care III database. A multivariate Cox regression model was used to assess the independent association of BMI with the primary outcome. Results. A total of 7,967 patients were enrolled in this study. Firstly, we found that the 28-day mortality was reduced by 22% ( HR = 0.78 , 95% CI 0.69–0.88) and 13% ( HR = 0.87 , 95% CI 0.78–0.98) for obese and overweight compared to normal weight, respectively. Subsequently, a U-shaped association of BMI with 28-day mortality was observed in sepsis patients, with the lowest 28-day mortality at the BMI range of 30–40 kg/m2. Finally, significant interactions were observed only for sex ( P = 0.0071 ). Male patients with a BMI of 25-30 kg/m2 ( HR = 0.74 , 95% CI 0.63–0.86) and 30-40 kg/m2 ( HR = 0.63 , 95% CI 0.53–0.76) had a significantly lower risk of 28-day mortality. Conclusions. A U-shaped association of BMI with 28-day mortality in critically ill sepsis patients was found, with the lowest 28-day mortality at a BMI range of 30–40 kg/m2. Notably, male patients were protected by a higher BMI more effectively than female patients as males had a significantly lower mortality risk.

scholarly journals The Association between Body Mass Index and Mortality on Peritoneal Dialysis: A Prospective Cohort Study

2014 ◽  
Vol 34 (4) ◽  
pp. 383-389 ◽  
Author(s):  
Yong Kyun Kim ◽  
Su-Hyun Kim ◽  
Hyung Wook Kim ◽  
Young Ok Kim ◽  
Dong Chan Jin ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cohort Study ◽  
Peritoneal Dialysis ◽  
Body Mass ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cox Regression ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Cox Regression Analysis

BackgroundPrevious studies have demonstrated that increased body mass index (BMI) is associated with decreased mortality in hemodialysis (HD) patients. However, the association between BMI and survival has not been well established in patients undergoing peritoneal dialysis (PD). The aim of the study was to determine the association between BMI and mortality in the PD population using the Clinical Research Center (CRC) registry for end-stage renal disease (ESRD) cohort in Korea.MethodsPrevalent patients with PD were selected from the CRC registry for ESRD, a prospective cohort study on dialysis patients in Korea. Patients were categorized into four groups by quartiles of BMI. Cox regression analysis was used to calculate the adjusted hazard ratio (HR) of mortality with a BMI of quartile 2 (21.4 - 23.5 kg/m2) as the reference.ResultsA total of 900 prevalent patients undergoing PD were included. The median follow-up period was 24 months. The multivariate Cox proportional hazard model showed that the lowest quartile of BMI was associated with higher mortality (HR 3.00,95% confidence interval (CI), 1.26 - 7.15). However, the higher quartiles of BMI were not associated with mortality compared with the reference category of BMI quartile 2 (Quartile 3: HR 1.11, 95% CI, 0.43 - 2.85, Quartile 4: H R 1.64,95% CI, 0.66 - 4.06) after adjustment for clinical variables.ConclusionsLower BMI was a significant risk factor for death, but increased BMI was not associated with mortality in Korean PD patients.

scholarly journals Total SOFA and SOFA Kidney are Associated with Short Term and Long term Outcoming of Sepsis-Associated Liver Injury

2021 ◽  
Author(s):  
He Miao ◽  
Hong Liang ◽  
Yuteng Ma ◽  
Cong Tian ◽  
Yanan Ma ◽  
...  
Keyword(s):  
Intensive Care ◽  
Liver Injury ◽  
Sofa Score ◽  
Medical Information ◽  
Close Association ◽  
Confounding Factors ◽  
Icu Mortality ◽  
Short Term ◽  
Mimic Iii

Abstract Background: Liver injury is considered as a common complication of sepsis. However, there are still few studies on short-term and long-term prognostic factors of sepsis-associated liver injury (SALI). The objective of our study is to conduct a large sample data cohort study to explore the risk factors for short-term and long-term prognosis of SALI.Methods: Data from a public, US-based, critical-care database (Medical Information Mart for Intensive Care-III [MIMIC-III]) was used. Septic patients who met the definition of acute liver injury were enrolled. Variables extracted from MIMIC-III were used to evaluate patient demographics, clinical characteristics on Day 1 of intensive care unit admission, and clinical outcomes. The Logistic regression models were used to calculate risk ratio (RR) and 95% confidence intervals (CIs) after adjusting for potential factors. Results: Among the 14687 participants in our study, there were 3140 (21.38%) with SALI. SALI was significantly positively associated with ICU mortality (RR, 1.54; 95% CI, 1.32, 1.79), 28-day mortality (RR, 1.27; 95% CI, 1.11, 1.45) and 1-year mortality (RR, 1.19; 95% CI, 1.06, 1.34) after adjusting confounding factors. Stratified by SOFA, there was a positive association between SALI and ICU mortality (RR, 2.15; 95% CI, 1.64, 2.80), 28-day mortality (RR, 1.60; 95% CI, 1.28, 1.99), 1-year mortality (RR, 1.24; 95% CI, 1.04, 1.48) after adjusting confounding factors among people with sofa score ≤ 5. Similar results were also obtained between SALI and ICU mortality (RR,1.40; 95% CI, 1.17, 1.67), 28-day mortality (RR, 1.17; 95% CI, 0.99, 1.38), 1-year mortality (RR, 1.19; 95% CI, 1.02, 1.38) after adjusting confounding factors among people with sofa score> 5. Compared with SOFA renal> 1, SALI had a stronger positive correlation with ICU mortality (RR, 1.36; 95% CI, 1.01, 1.84), 28-day mortality (RR, 1.19; 95% CI, 0.91, 1.56), 1-year mortality (RR, 1.11; 95% CI, 0.88, 1.41) after adjusted confounding factors among people with SOFA renal ≤ 1.Conclusions: SALI was an independent risk factor for ICU mortality, 28-day mortality and 1-year mortality. And there is a close association between liver and kidney in sepsis, but the mechanism is still unclear and requires further study.

scholarly journals Triglyceride Glucose-Body Mass Index and The Risk of Diabetes: A General Population-Based Cohort Study

2021 ◽  
Author(s):  
Xiaoyu Wang ◽  
Jingdong Liu ◽  
Zongyou Cheng ◽  
Yanjia Zhong ◽  
Xiaohua Chen ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cohort Study ◽  
Body Mass ◽  
Cox Regression ◽  
Causal Association ◽  
Middle Aged ◽  
Obese People ◽  
Cox Regression Analysis ◽  
Onset Diabetes ◽  
New Onset

Abstract Background: Triglyceride glucose-body mass index (TyG-BMI) has been proven to be a reliable substitute for insulin resistance. However, whether a causal association exists between TyG-BMI and new-onset diabetes remains uncertain. The purpose of this study was to investigate the causal association and predictive performance between TyG-BMI and diabetes.Methods: A total of 116661 subjects who underwent a physical examination were included in this study. The subjects were divided into five equal points according to the quintile of TyG-BMI, and the outcome of interest was the occurrence of diabetic events. TyG-BMI = ln [fasting plasma glucose (mg/dL) × fasting triglycerides (mg/dL)/2] × BMI.Results: During the average follow-up period of 3.1 (0.95) years, 1888 men (1.61%) and 793 women (0.68%) were newly diagnosed with diabetes. Multivariate Cox regression analysis showed that TyG-BMI was an independent predictor of new-onset diabetes (HR 1.50 per SD increase, 95%CI: 1.40 to 1.60, P-trend<0.00001), and the best TyG-BMI cutoff value for predicting new-onset diabetes was 213.2966 (area under the curve 0.7741, sensitivity 72.51%, specificity 69.54%). Additionally, the results of subgroup analysis suggested that the risk of TyG-BMI-related diabetes in young and middle-aged people was significantly higher than that in middle-aged and elderly people, and the risk of TyG-BMI-related diabetes in non-obese people was significantly higher than that in overweight and obese people (P for interaction <0.05).Conclusions: This cohort study of the Chinese population shows that after excluding other confounding factors, there is a causal association of TyG-BMI with diabetes, and this independent association is more obvious in young, middle-aged and non-obese people.

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