The association between body mass index and outcomes in patient with sepsis and acute respiratory failure
Background: Patients with increased body mass indices (BMIs) often present practical
problems during their management for acute medical disorders in intensive care units. Some
studies suggested obese patients have longer ICU stays but lower in-hospital mortality rates.
This study considers the effect of BMI on outcomes in patients with sepsis and respiratory
Methods: The electronic medical records of patients hospitalized between 2010 and
2016 with sepsis who required mechanical ventilation were reviewed to collect demographic
characteristics, clinical information including BMI subcategory, management requirements,
and outcomes, such as mortality, ICU length of stay (LOS), and hospital LOS.
Results: This study included 312 adult patients. The mean age was 59.1 ± 16.3 years;
57.4% were men. The mean BMI was 29.3 ± 10.7 kg/m2. The median APACHE II score was
14, 46.2 % of the patients had pulmonary infections, and 34.9% had extrapulmonary infections.
The overall mortality was 42.6%. The mean LOS was 12.4 ± 11.8 days in the ICU and
16.6 ± 13.6 days in the hospital. The mortality rates were 38.5% in underweight patients (BMI
<18.5kg/m2), 51.1% in normal weight patients (BMI 18.5–24.9 kg/m2), 38.5% in overweight
patients (BMI 25–29.9 kg/m2), and 40.2% in obese patients (BMI >30 kg/m2). Body mass index
did not have an independent effect on mortality after adjusting for age, gender, and APACHE
II scores; however, overweight patients required more mechanical ventilation days and had an
increased LOS in the ICU and the hospital.
Conclusions: This study demonstrates that patients with sepsis requiring mechanical
ventilation have a high mortality rate and that BMI did not have an effect on mortality. A
prospective study which considers differences in clinical characteristics, management
requirements, complications, and inflammatory parameters in different BMI subcategories is
needed. Overweight patients had an increased ICU and hospital LOS.
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