Impact of Obesity on Outcomes in Critically Ill Children

Davis, Esther T.; Xie, Liping; Levenbrown, Yosef

doi:10.1177/0148607117725043

Cited by 7 publications

(11 citation statements)

References 43 publications

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“…On the other hand, several studies have reported no association between BMI and mortality of critically ill patients. Supporting this claim, a recent study showed that although obesity decreases the need for intubation and inotropic support, evidence are not sufficient to support the increasing or decreasing mortality of patients (20). Another study on 312 patients with sepsis and acute respiratory failure showed that even though overweight and obese patients had an increased LoS in both hospital and ICU, there was no association between BMI and mortality rate (21).…”

Section: Discussionmentioning

confidence: 99%

Impact of Body Mass Index on the Mortality of Critically Ill Patients Admitted to the Intensive Care Unit: An Observational Study

et al. 2020

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Background: Obesity is a severe multifactorial disorder that carries high morbidity and mortality. Objectives: This study aimed to evaluate the possible association between body mass index (BMI) and mortality in patients admitted to intensive care units (ICU). Methods: In this cross-sectional study, all patients admitted to the ICU were studied. The demographic characteristics, ICU, and hospital length of stay, organ failure, mortality, duration of mechanical ventilation, the occurrence of nosocomial infection, and type of admission were recorded for all patients. Patients were categorized based on their BMI. Results: In total, 502 patients were studied who 53.2% of them were male. Most of the death (28.6%) were recorded in the obesity class II patients, while the lowest rate (3.9%) was for the normal-weight patients (P value < 0.001). The APACHE II and waist circumference had a statistically significant association with the mortality rate (P value < 0.001). After adjusting for age and gender, a significant association was found between waist circumference and mortality rate (OR = 1.15, 95% CI = 1.03 - 1.29; P value = 0.014), APACHE II score, and mortality rate (OR = 2.79, 95% CI = 1.91 - 4.07, P value < 0.001); but there was no significant association between BMI and mortality rate. Conclusions: This study demonstrated that BMI is associated with an increased risk of mortality, regardless of age and gender. However, after adjusting for age and gender as confounding factors, BMI didn’t have a significant effect on mortality, while the APACHE II score and waist circumference affected the mortality rate.

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Section: Discussionmentioning

confidence: 99%

Impact of Body Mass Index on the Mortality of Critically Ill Patients Admitted to the Intensive Care Unit: An Observational Study

et al. 2020

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“…Regarding the methods used to assess and classify nutrition status, the present study also differs from some previous studies. 13,14,16 For assessment of nutrition status, we only used WHO curves, the current international standard of optimal growth and development. Categories were established on the basis of BMI z-scores, chosen for their applicability to the entire study age range.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12] An association has been proposed between overweight and pediatric PICU mortality 13 ; however, the literature so far shows heterogeneous studies producing conflicting results. [14][15][16] The objective of the present study was to determine whether excess weight is associated with clinical outcomes in critically ill children and adolescents admitted to the PICU.…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes in Critically Ill Children With Excess Weight: A Retrospective Cohort Study

et al. 2020

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Background: Because of its high prevalence and negative impact on quality of life and longevity, overweight in childhood and adolescence is a major public health concern. The objective of the present study was to determine whether excess weight is associated with clinical outcomes in critically ill children and adolescents admitted to the pediatric intensive care unit (PICU). Method: This retrospective cohort study was performed with children and adolescents admitted to a PICU over 3 years. Nutrition status was classified based on the body mass index z-score for age, following World Health Organization (WHO) criteria. The following outcomes were assessed: mortality, need for mechanical ventilation, length of admission, and multiple organ dysfunction syndrome. Results: Of 1468 patients admitted during the study period, 1407 were included in the study: 956 (68.0%) had adequate weight, 228 (16.2%) were overweight, and 223 (15.8%) were underweight. Associations were detected between most variables and all nutrition categories (underweight, adequate weight, and overweight). In the descriptive analysis, mortality was more prevalent in nutrition status extremes (extremely underweight or overweight). An independent association between nutrition status and mortality was not detected in any category. Conclusion: Nutrition status was not independently associated with poor outcomes. However, overweight should be considered a potential risk factor for adverse clinical outcomes in PICU admissions.

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“…On the other hand, many studies have claimed that there is no correlation between the BMI and mortality outcomes of critically ill patients. Supporting this claim, a recent study showed although obesity has a direct impact on reducing the need of intubation and inotropic support, there is no signi cant evidence of an increase or decreasing in patients' mortality [26]. Another study on 312 patients with sepsis and acute respiratory failure showed that even though overweight and obese patients have an increased length of stay in both hospital and ICU, BMI is independent of mortality rate [27].…”

Section: Discussionmentioning

confidence: 99%

“…Still, obesity was signi cantly associated with longer length of stay and increased comorbid illness [28]. Recent studies are intended to evaluate the issue in larger study populations, among different subgroups, and according to the etiology context [26,29,30]. A recent dose-response meta-analysis regarding the effect of BMI on the mortality of ICU-admitted patients showed that for each unit of increase in BMI (kg/m2), a 0.6% decrease in mortality rate is expected [31].…”

Section: Discussionmentioning

confidence: 99%

Impact of Body Mass Index on the Mortality of Critically Ill Patients Admitted to the Intensive Care Unit: An Observational Study

Mahmoodpoor

Karrubi

Hosseini

et al. 2020

Preprint

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Background: Obesity, a wide-ranging disorder all around the world, is associated with significant morbidity and mortality in the general population. Regarding the present controversies, this study aims to evaluate the possible association of body mass index (BMI) and mortality in patients admitted to intensive care units.Methods: During this cross-sectional study, all patients admitted to the intensive care unit of two university affiliated hospitals in northwest of Iran from November 2017 to March 2019 were enrolled. The demographic characteristics of patients, length of stay in the intensive care unit and hospital, organ failure, mortality, duration of mechanical ventilation and vasopressor-therapy, type of nutrition, the occurrence of nosocomial infection, type of admission (medical, surgical, trauma) were recorded for all patients. According to the WHO classification of BMI, patients were divided into the six groups, and the data were analyzed accordingly.Results: Of the 502 patients studied, 267 were male (53.2%) and 235 were female (46.8%). The highest mortality rate was observed among the obesity class II patients (35 < BMI < 40) with 28.6%, while the lowest rate was observed in the normal-weight patients (18.5 < BMI < 25) with 3.9%. The highest length of hospital stay was seen in patients with BMI > 30 with 12 days of hospitalizations. APACHE II and waist circumference had a statistically significant relationship with the mortality rate of patients (P-value < 0.001).Conclusion: The current study showed that BMI could be related to mortality, regardless of waist circumference and APACHE II score. However, considering waist circumference and APACHE II score as confounding factors, BMI does not have a significant effect on mortality and only affect the morbidity of patients.

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Impact of Obesity on Outcomes in Critically Ill Children

Cited by 7 publications

References 43 publications

Impact of Body Mass Index on the Mortality of Critically Ill Patients Admitted to the Intensive Care Unit: An Observational Study

Impact of Body Mass Index on the Mortality of Critically Ill Patients Admitted to the Intensive Care Unit: An Observational Study

Clinical Outcomes in Critically Ill Children With Excess Weight: A Retrospective Cohort Study

Impact of Body Mass Index on the Mortality of Critically Ill Patients Admitted to the Intensive Care Unit: An Observational Study

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