Association between obesity and 1-year mortality in septic patients: a retrospective cohort study

Abstract

ObjectiveSepsis is a major contributor of intensive care units (ICUs) patient mortality. Prior investigations claimed that obesity enhances overall survival (OS) of septic patients. However, the reported results were inconsistent. This study examined the association between obesity and the 1-year mortality of septic patients.DesignA retrospective cohort study.SettingThe Medical Information Mart for Intensive Care III database.Participants3145 septic patients were separated into three distinct cohorts, based on their WHO body mass index (BMI) status.OutcomesOur primary endpoint was the 1-year mortality from the date of ICU hospitalization.Result1334 (42.4%) died within 1 year. The 1-year mortality rate was low in obese patients (38.8%), compared with normal (46.9%) and overweight (42.1%) patients. Crude assessment revealed that obese patients experienced reduced 1-year mortality, relative to normal weight patients (HR 0.79, 95% CI 0.69 to 0.9, p<0.001). However, once adjusted for baseline variables and comorbidities, no correlation was found between obesity and the 1-year mortality (HR 0.93, 95% CI 0.81 to 1.06, p=0.28) of septic patients. There was an association among diabetic (HR 0.72, 95% CI 0.56 to 0.93, p=0.012) and hypertensive (HR 0.73, 95% CI 0.58 to 0.92, p=0.008) patients, and among males (HR 0.71, 95% CI 0.59 to 0.86, p<0.001), with obese individuals experiencing the lowest mortality rate. Given these evidences, the interactions between BMI and mortality in diabetic (p=0.031) and hypertensive (p=0.035) patients were significant.ConclusionIn our study, obese diabetic and hypertensive patients associated to less sepsis-related mortality risk, compared with normal weight patients. Further researches were need to validated.

Association of obesity and mortality in sepsis patients: A meta-analysis from observational evidence

“…A total of 3865 records were identified via a systematic search of databases published before March 28, 2023, and screened for inclusion based on eligibility criteria. After reviewing the titles and abstracts, 12 studies [ [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] ] were selected for inclusion in this study. Specifically, these studies reported on the association between obesity and sepsis prognosis, with 8 [ 14 , [16] , [17] , [18] , [19] , [20] , [21] , 23 ] of them focusing on overweight patients and 6 [ 14 , 16 , 18 , 20 , 21 , 35 ] of them restricting the analysis to patients with low weight.…”

“…This meta-analysis comprised 12 studies [ [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] ] encompassing data from multiple countries or regions with a total of 521,207 individuals, and two of which were prospective cohort studies. The follow-up time varied across the studies.…”

“…Twelve cohort studies [ [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] ] were included in this meta-analysis to explore the associations between obesity and the risk of mortality in sepsis (OR = 0.82; 95% CI: 0.69–0.97; I 2 = 86.1%, P < 0.001; Fig. 2 ).…”

“…Active monitoring of suspected risk factors for sepsis was essential to prevent and treat sepsis. Recent studies have shown that obesity, body weight, and Body Mass Index (BMI) were important factors related to sepsis [ [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] ].…”

“…Previous studies [ 24 ] have found that obesity is a risk factor for increased sepsis mortality. In addition, in six studies [ 15 , 17 , 19 , 20 , 22 , 25 ], obesity was not associated with sepsis mortality. However, these were contradictions in their conclusions.…”