The Role of Obesity in Sepsis Outcome among Critically Ill Patients: A Retrospective Cohort Analysis

Abstract

Background. The objective of this study was to assess the correlation between sepsis, obesity, and mortality of patients admitted to an Intensive Care Unit (ICU). Subjects and Methods. Data of all patients admitted to the ICU of a tertiary hospital during a 28-month period were retrospectively analyzed and included in the study. Results. Of 834 patients included, 163 (19.5%) were obese, while 25 (3.0%) were morbidly obese. Number of comorbidities (P < 0.001), bloodstream infection (P 0.033), and carbapenemase-producing Klebsiella pneumoniae colonization during ICU stay (P 0.005) were significantly associated with obesity, while nonobese patients suffered more frequently from spontaneous intracranial hemorrhage (P 0.038). Total ICU mortality was 22.5%. Increased mortality among obese ICU patients was observed. Sepsis was the main condition of admission for which obese patients had statistically lower survival than normal weight subjects (76.3% versus 43.7%; P 0.001). Mortality of septic patients upon admission was independently associated with SOFA score upon ICU admission (P 0.003), obesity (P 0.014), pneumonia (P 0.038), and development of septic shock (P 0.015). Conclusions. Our study revealed that sepsis upon ICU admission is adversely influenced by obesity but further studies are needed in order to assess the role of obesity in sepsis outcome.

Increased body mass index linked to greater short- and long-term survival in sepsis patients: A retrospective analysis of a large clinical database

“…Furthermore, our findings suggested that there was a trend towards extended periods of ventilation, longer ICU and hospital LOS in obese patients, as prior studies have reported (Papadimitriou-Olivgeris et al, 2016;Sakr et al, 2015). This finding is mainly attributed to higher risks of nosocomial infection and respiratory complications (Sakr et al, 2008) that are associated with obesity.…”

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

“…Regarding the association of BMI and hospital infection, the present study demonstrated that the patients with BMI < 18.5 had the highest rate of hospital infection, while the normal-BMI patients had the lowest rate. A retrospective cohort study by Papadimitriou-Olivgeris et al supports the current results [34]. The study, focused on the role of obesity in the prognosis of sepsis patients, revealed that obesity had a direct impact on some morbidities, including bloodstream infection and Klebsiella pneumonia colonization, concluding that obesity affects sepsis upon ICU admission.…”

Predictors for delayed antibiotic administration among bacteraemic patients in the Emergency Department: Differences between medical and surgical interns

“…20 As previously discussed, multidrug resistance was scarce in our population, thus our findings may not be generalizable to countries with high percentages of multidrug-resistant pathogens. 17,21 Another limitation, was that we included only patients with bacteraemia and not patients with suspected infection or those with sepsis.…”