Being Overweight Is Associated With Greater Survival in ICU Patients: Results From the Intensive Care Over Nations Audit.

Sakr, Yasser; Alhussami, Ilmi; Nanchal, Rahul; Wunderink, Richard G; Pellis, Tommaso; Wittebole, Xavier; Martin-Loeches, Ignacio; François, Bruno; Leone, Marc; Vincent, Jean-Louis (2015). Being Overweight Is Associated With Greater Survival in ICU Patients: Results From the Intensive Care Over Nations Audit. Critical care medicine, 43(12), pp. 2623-2632. Lippincott Williams & Wilkins 10.1097/CCM.0000000000001310

[img] Text
2016_Jakob_PubMed 26427591.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (566kB) | Request a copy

OBJECTIVE To assess the effect of body mass index on ICU outcome and on the development of ICU-acquired infection. DESIGN A substudy of the Intensive Care Over Nations audit. SETTING Seven hundred thirty ICUs in 84 countries. PATIENTS All adult ICU patients admitted between May 8 and 18, 2012, except those admitted for less than 24 hours for routine postoperative monitoring (n = 10,069). In this subanalysis, only patients with complete data on height and weight (measured or estimated) on ICU admission in order to calculate the body mass index were included (n = 8,829). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Underweight was defined as body mass index less than 18.5 kg/m, normal weight as body mass index 18.5-24.9 kg/m, overweight as body mass index 25-29.9 kg/m, obese as body mass index 30-39.9 kg/m, and morbidly obese as body mass index greater than or equal to 40 kg/m. The mean body mass index was 26.4 ± 6.5 kg/m. The ICU length of stay was similar among categories, but overweight and obese patients had longer hospital lengths of stay than patients with normal body mass index (10 [interquartile range, 5-21] and 11 [5-21] vs 9 [4-19] d; p < 0.01 pairwise). ICU mortality was lower in morbidly obese than in normal body mass index patients (11.2% vs 16.6%; p = 0.015). In-hospital mortality was lower in morbidly obese and overweight patients and higher in underweight patients than in those with normal body mass index. In a multilevel Cox proportional hazard analysis, underweight was independently associated with a higher hazard of 60-day in-hospital death (hazard ratio, 1.32; 95% CI, 1.05-1.65; p = 0.018), whereas overweight was associated with a lower hazard (hazard ratio, 0.79; 95% CI, 0.71-0.89; p < 0.001). No body mass index category was associated with an increased hazard of ICU-acquired infection. CONCLUSIONS In this large cohort of critically ill patients, underweight was independently associated with a higher hazard of 60-day in-hospital death and overweight with a lower hazard. None of the body mass index categories as independently associated with an increased hazard of infection during the ICU stay.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0090-3493

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Mirella Aeberhard

Date Deposited:

19 Jun 2018 09:23

Last Modified:

19 Jun 2018 09:23

Publisher DOI:

10.1097/CCM.0000000000001310

PubMed ID:

26427591

Additional Information:

Forschungsgruppe "Intensive Care Over Nations Investigators" / Mitarbeit: Jakob Stephan, Universitätsklinik für Intensivmedizin / Tätigkeit: Datacollection, Participation in meetings where the manuscript was discussed

BORIS DOI:

10.7892/boris.93484

URI:

https://boris.unibe.ch/id/eprint/93484

Actions (login required)

Edit item Edit item
Provide Feedback