Association of body mass index and hypoglycemia with mortality rates among sepsis patients: a retrospective sub-analysis of the FORECAST Study

Abstract We assessed the influence of admission hypoglycemia on mortality in sepsis patients according to body mass index (BMI). We included 1,184 patients (age ≥ 16 years) with severe sepsis diagnosed using Sepsis-2 criteria. The outcome was in-hospital mortality. Using multivariate logistic regression, we examined the association between hypoglycemia and in-hospital mortality. Overall, 1,103 patients were analyzed. Patients were divided into groups according to the initial blood glucose level, i.e., < 70 (hypoglycemia) or ≥ 70 (non-hypoglycemia) mg/dL, and BMI, i.e., < 18.5 (low), 18.5–24.9 (normal), or ≥ 25 (high) kg/m2. Hypoglycemia was noted in 65 patients, with low (n = 13), normal (n = 38), and high BMI (n = 14). Hypoglycemia patients showed higher in-hospital mortality than those without in the normal BMI group but not in the low and high BMI groups. In multivariate logistic regression, hypoglycemia was non-significantly associated with higher mortality in all patients (p = 0.268). However, there was a significant interaction between normal BMI patients and hypoglycemia on in-hospital mortality but not between low or high BMI patients and hypoglycemia (p = 0.0476). Hypoglycemia at admission in sepsis patients was associated with high mortality in normal BMI patients but not in low or high BMI patients. This association may be used as a prognostic marker in sepsis patients.

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Association of Body Mass Index and Hypoglycaemia with Mortality Rates Among Sepsis Patients: A Retrospective Sub-Analysis of the FORECAST Study

10.21203/rs.3.rs-615999/v1 ◽

2021 ◽

Author(s):

Atsushi Tanikawa ◽

Daisuke Kudo ◽

Hiroyuki Ohbe ◽

Shigeki Kushimoto

Keyword(s):

Body Mass Index ◽

Logistic Regression ◽

Hospital Mortality ◽

Regression Model ◽

Glucose Level ◽

High Mortality ◽

Logistic Regression Model ◽

Multivariate Logistic Regression Model ◽

Multivariate Logistic Regression ◽

High Bmi

Abstract Background: Hypoglycaemia at admission is associated with high mortality in sepsis patients. The association of hypoglycaemia and body mass index (BMI) with mortality in sepsis patients has not been clarified. We aimed to assess the influence hypoglycaemia at admission on mortality in sepsis patients according to BMI categories.Methods: This was a secondary analysis of a multicentre, prospective cohort study of 59 intensive care unit in Japan. The study included 1,184 patients (age ≥16 years) with severe sepsis; the diagnosis was made based on the Sepsis-2 criteria. After excluding patients with missing data of glucose level, BMI, or survival at discharge, patients were divided into groups according to the initial blood glucose level, <70 (hypoglycaemia) or ≥70 (non-hypoglycaemia) mg/dL, and according to BMI categories, <18.5 (low), 18.5–24.9 (normal), and ≥25 (high) kg/m2. The main outcome measure was in-hospital mortality. A multivariate logistic regression model was used to examine the association between hypoglycaemia and in-hospital mortality. BMI category-by-hypoglycaemia interactions were evaluated to assess the heterogeneity of the impact of hypoglycaemia on in-hospital mortality across BMI categories.Results: In total, 1,103 patients, including 65 patients with hypoglycaemia, were analysed. Among patients with hypoglycaemia, 13 had low, 38 had normal, and 14 had high BMI. Patients with hypoglycaemia showed higher in-hospital mortality (18/38, 47.4%) than those without hypoglycaemia (119/584, 20.4%) in the normal BMI group but not in the low and high BMI groups. In the multivariate logistic regression model, hypoglycaemia was not significantly associated with higher mortality in all patients (odds ratio [OR] 1.41; 95% confidence interval [CI] 0.77–2.58). However, there was a significant interaction between patients with normal BMI and hypoglycaemia on in-hospital mortality but not between patients with low or high BMI and hypoglycaemia (OR 2.32, 95% CI 1.05–5.07), and p for interaction: 0.0476).Conclusions: Hypoglycaemia at admission in sepsis patients was associated with high mortality in patients with normal BMI, but not in those with low or high BMI. This association may be used as a prognostic marker in sepsis patients.

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Short-Term Outcomes Following Removal of Infected Hernia Mesh

The American Surgeon ◽

10.1177/00031348211024189 ◽

2021 ◽

pp. 000313482110241

Author(s):

Christine Tung ◽

Junko Ozao-Choy ◽

Dennis Y. Kim ◽

Christian de Virgilio ◽

Ashkan Moazzez

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Logistic Regression ◽

Body Mass ◽

Smoking History ◽

Multivariate Logistic Regression ◽

Short Term ◽

Mesh Removal ◽

Mesh Placement ◽

Infected Mesh

There are limited studies regarding outcomes of replacing an infected mesh with another mesh. We reviewed short-term outcomes following infected mesh removal and whether placement of new mesh is associated with worse outcomes. Patients who underwent hernia repair with infected mesh removal were identified from 2005 to 2018 American College of Surgeons-National Surgical Quality Improvement Program database. They were divided into new mesh (Mesh+) or no mesh (Mesh-) groups. Bivariate and multivariate logistic regression analyses were used to compare morbidity between the two groups and to identify associated risk factors. Of 1660 patients, 49.3% received new mesh, with higher morbidity in the Mesh+ (35.9% vs. 30.3%; P = .016), but without higher rates of surgical site infection (SSI) (21.3% vs. 19.7%; P = .465). Mesh+ had higher rates of acute kidney injury (1.3% vs. .4%; P = .028), UTI (3.1% vs. 1.3%, P = .014), ventilator dependence (4.9% vs. 2.4%; P = .006), and longer LOS (8.6 vs. 7 days, P < .001). Multivariate logistic regression showed new mesh placement (OR: 1.41; 95% CI: 1.07-1.85; P = .014), body mass index (OR: 1.02; 95% CI: 1.00-1.03; P = .022), and smoking (OR: 1.43; 95% CI: 1.05-1.95; P = .025) as risk factors independently associated with increased morbidity. New mesh placement at time of infected mesh removal is associated with increased morbidity but not with SSI. Body mass index and smoking history continue to contribute to postoperative morbidity during subsequent operations for complications.

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Influence of overweight on functional capacity of physically active older women

Brazilian Journal of Kinanthropometry and Human Performance ◽

10.1590/1980-0037.2020v22e67000 ◽

2020 ◽

Vol 22 ◽

Author(s):

Akeline Santos de Almeida ◽

Patrícia Almeida Fontes ◽

Jamille Mendonça Reinaldo ◽

Maria de Lourdes Feitosa Neta ◽

Ricardo Aurélio Carvalho Sampaio ◽

...

Keyword(s):

Body Mass Index ◽

Logistic Regression ◽

Older Women ◽

Body Mass ◽

Functional Capacity ◽

Negative Correlation ◽

The Body ◽

Lower Limbs ◽

Multivariate Logistic Regression ◽

Physically Active

Abstract Aging comprises a dynamic and progressive process, characterized by physiological and functional changes. Among these changes, increase in body fat is considered relevant, since it can leads to impaired physical fitness and augmented cardiometabolic risks. Considering this, the objective of this study was to evaluate the influence of overweight on functional capacity of physically active older women. A field survey was performed with 24 older women who practiced physical exercise. Participants were submitted to anamnesis, anthropometric measures (i.e., body mass and height); the Senior Fitness test; sit and reach flexibility test; and handgrip strength test. Pearson’s correlation test and multivariate logistic regression were used to verify the association between overweight and functional capacity. It was observed that hip flexibility (R=-0.494, p=0.014) and flexibility of the lower limbs (i.e., sit and reach test) showed negative correlation with the body mass index (R=-0.446, p=0.02); and after the multivariate logistic regression, negative correlation of lower limbs flexibility (B=-0,035, p=0,014) and the body mass index was observed. Thus, higher the body mass index among participants, lower hip flexibility they presented.

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P3795Should we also screen for obstructive sleep apnea in patients presenting with excessive supraventricular ectopic activity?

European Heart Journal ◽

10.1093/eurheartj/ehz745.0640 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

R Marinheiro ◽

L Parreira ◽

P Amador ◽

D Mesquita ◽

J Farinha ◽

...

Keyword(s):

Atrial Fibrillation ◽

Body Mass Index ◽

Logistic Regression ◽

Body Mass ◽

Strong Evidence ◽

Multivariate Logistic Regression Analysis ◽

P Value ◽

Ectopic Activity ◽

Multivariate Logistic Regression ◽

Obstructive Sleep

Abstract Background It is recommended to consider obstructive sleep apnoea (OSA) screening in atrial fibrillation (AF) patients with risk factors, due to the strong evidence of an association between these two entities. Excessive supraventricular ectopic activity (ESVEA) has been proposed to be a risk factor for AF. However, strong evidence between ESVEA and OSA has not been established. Objective We aimed to determine if ESVEA is associated with moderate to severe OSA since its treatment may prevent AF. Methods We studied patients who performed polysomnography and 24-hour Holter monitoring. Patients with atrial fibrillation were excluded. ESVEA was defined as more than 30 PACs per hour (frequent PACs) or runs of >4 consecutive PACs. The circadian pattern of PACs was also evaluated. Sleeping hours were used to define “nocturnal”. Moderate to severe OSA was defined when polyssonography demonstrated a apnoea/hypopnoea index (AHI) >15. We examined the association between ESVEA and moderate to severe OSA during wakefulness and sleep. Results We studied 290 patients [median age 65 (55–72) years, 62% males, body mass index (BMI) 30 (27–34)]. 112 (38%) had moderate to severe OSA. Median AHI was 11 (5–24) and mean oxygen saturation was 94% (92–95). Median PACs was 35 (9–117) and 29 patients (10%) had frequent PACs. Runs of >4PACs occurred in 114 patients (39%). Forty-three patients (15%) had predominant nocturnal PACs and 42 (14%) had nocturnal runs of PACs. Multivariate logistic regression analysis demonstrated only nocturnal PACs were associated with moderate to severe OSA (p=0.027) (table 1). Multivariate logistic regression Odds Ratio 95% Confidence Interval p-value Male gender 4.49 2.48–8.17 <0.001 Body mass index (kg/m2) 1.09 1.03–1.15 0.002 Nocturnal PACs 4.12 1.17–14.46 0.027 Variables not included in the model: age, number of PACs/h, frequent PACs (>30 PAcs/hour), runs of PACs (>4 consecutive PACs), nocturnal frequent PACs and nocturnal runs of PACs. Conclusion OSA screening in patients presenting with nocturnal PACs should be routinely considered, especially in male and obese. Treating moderate to severe OSA patients with CPAP has a potential benefit in preventing ESVEA and consequently AF.

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Value of visceral fat area in normal body mass index (BMI) patients is a predictive factor for peritoneal metastasis in gastric cancer: A prospective study

10.21203/rs.3.rs-15896/v1 ◽

2020 ◽

Author(s):

Chenchen Mao ◽

Mingming Shi ◽

Hui Chen ◽

Libin Xu ◽

He Huang ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Body Mass Index ◽

Logistic Regression ◽

Body Mass ◽

Peritoneal Metastasis ◽

Visceral Fat ◽

Visceral Fat Area ◽

Cutoff Values ◽

High Bmi

Abstract Background Although peritoneal metastasis (PM) is associated with poor prognosis in gastric cancer (GC) patients, it is difficult to discriminate preoperatively. Our previous study has demonstrated visceral fat area (VFA) is a better obesity index than body mass index (BMI) in predicting abdominal metastasis. Aim This study aimed to further explore the relationship between obesity and PM. Methods VFA was retrieved for 859 consecutive patients undergoing radical gastrectomy between January 1, 2009 and December 31, 2013. A receiver operating characteristic curve analysis was used to determine the BMI-specific cutoff values for VFA. Univariate and multivariate analyses evaluating the risk factors for PM at different BMI levels were performed. Results The optimal cutoff values for VFA were 67.28, 88.03, and 175.32 cm 2 for low, normal, and high BMI patients, respectively, and 18 (15.52%), 220 (40.15%), and 61 (31.28%) patients were classified as having high VFA in each group. Univariate logistic regression revealed that the association between high VFA and PM was not dependent on BMI (odds ratio [OR]=9.048, P=0.007 for low BMI, OR=3.827, P<0.001 for normal BMI, and OR=2.460, P=0.049 for high BMI). In multivariate logistic regression analysis, high VFA (OR=3.816, P<0.001) and vascular invasion (OR=1.951, P=0.039) were independent risk factors for PM only in the normal BMI group. Conclusions VFA only effectively predicted PM for GC patients with normal BMI, rather than those with low and high BMI. More attentions should be paid to those GC patients with high VFA and normal BMI.

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Prevalence of Atypical Disorders and Associated Factors in Undergraduate Students of Prince of Songkla University, Songkhla, Thailand

Journal of Health Science and Medical Research ◽

10.31584/jhsmr.201947 ◽

2019 ◽

Author(s):

Orapan Fumaneeshoat

Keyword(s):

Body Mass Index ◽

Eating Disorders ◽

Logistic Regression ◽

Body Mass ◽

Undergraduate Students ◽

Eating Attitudes ◽

Multivariate Logistic Regression ◽

Attitudes And Behaviors ◽

Prince Of Songkla University ◽

And Behaviors

Objective: To quantify the prevalence of eating disorders and factors associated with eating disorders among undergraduate students in Prince of Songkla University, Hat Yai Campus.Material and Methods: This study was a cross sectional descriptive study using random sampling by proportionate accidental sampling. We used the Thai Eating Attitudes Test-26 (EAT-26) for collecting information about eating attitudes. Participants who had scores equal or higher than 12 (≥12) were assumed to have atypical eating attitudes and behaviors. We used the R and R studio program to analyze information. Multivariate logistic regression was used for correlation analysis.Results: In this study, we had completed questionnaires from 500 students (response rate 65.6%). The overall prevalence of atypical eating attitudes and behaviors in undergraduate students in Prince of Songkla University, Hat Yai Campus was 37.2%. We found that overweight body mass index (BMI) (BMI 23.00-24.99 kg/m2) and obesity BMI (≥25.00 kg/m2) were significantly more prevalent in students with atypical eating attitudes and behaviors than normal BMI (18.50-22.99 kg/m2), with odds ratios of 3.3 [95% confidence interval (CI)=1.8-6.2] and 3.7 (95% CI=1.9-6.9), respectively. However, multivariate logistic regression revealed no associations between atypical eating attitudes and behaviors, sex, target weight, biological disease, psychological disease, current medication(s) or faculty. Atypical eating attitudes and behaviors were significantly associated only with body mass index BMI. The overweight and obese BMI groups had significantly increased risks of 3.3 and 3.7 times of atypical eating attitudes and behaviors compared to the normal group, with 95% CIs of 1.8-6.2 and 1.9-6.9, respectively.Conclusion: From this study, overweight BMI and obesity BMI were significantly more prevalent in students with atypical eating attitudes and behaviors than normal BMI. BMI was the only factor significantly associated with atypical eating attitudes and behaviors.

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Clinical variables of preoperative risk in thoracic surgery

Sao Paulo Medical Journal ◽

10.1590/s1516-31802003000300004 ◽

2003 ◽

Vol 121 (3) ◽

pp. 107-110 ◽

Cited By ~ 7

Author(s):

Ivete Alonso Bredda Saad ◽

Eduardo Mello De Capitani ◽

Ivan Felizardo Contrera Toro ◽

Lair Zambon

Keyword(s):

Body Mass Index ◽

Logistic Regression ◽

Regression Analysis ◽

Thoracic Surgery ◽

Body Mass ◽

Multivariate Logistic Regression Analysis ◽

Pulmonary Complications ◽

Postoperative Pulmonary Complications ◽

Multivariate Logistic Regression ◽

Surgery Duration

CONTEXT: Pulmonary complications are the most common forms of postoperative morbidity in thoracic surgery, especially atelectasis and pneumonia. The first step in avoiding these complications during the postoperative period is to detect the patients that may develop them. OBJECTIVE: To identify risk variables leading to early postoperative pulmonary complications in thoracic surgery. DESIGN: Prospective study. SETTING: Hospital das Clínicas, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. PATIENTS: 145 patients submitted to elective surgery were classified as low, moderate and high risk for postoperative pulmonary complications using a risk assessment scale. PROCEDURES: The patients were followed up for 72 hours after the operation. Postoperative pulmonary complications were defined as atelectasis, pneumonia, tracheobronchitis, wheezing, prolonged intubation and/or prolonged mechanical ventilation. MAIN MEASUREMENTS: Univariate analysis was applied in order to study these independent variables: age, nutritional status, body mass index, respiratory disease, smoking habit, spirometry and surgery duration. Multivariate logistic regression analysis was performed in order to evaluate the relationship between independent and dependent variables. RESULTS: The incidence of postoperative complications was 18.6%. Multivariate logistic regression analysis showed that the variables increasing the chances of postoperative pulmonary complications were wheezing (odds ratio, OR = 6.2), body mass index (OR = 1.15), smoking (OR = 1.04) and surgery duration (OR = 1.007). CONCLUSION: Wheezing, body mass index, smoking and surgery duration increase the chances of postoperative pulmonary complications in thoracic surgery

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