The Dose-Response Relationship Between Body Mass Index and Mortality in Subjects Admitted to the ICU With and Without Mechanical Ventilation.
BACKGROUND: Obesity has been associated with increased mortality in the general population, whereas a paradoxical relationship between higher body mass index and lower mortality has been referred to as the obesity paradox in critically ill patients. However, it remains unknown whether a particular s...
| Publicado en: | Respiratory Care Vol. 60; no. 7; pp. 983 - 992 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Jul2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109828118&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109828118 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Jul2015 vid: 60 iid: 7 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 109828118 108375775 10.4187/respcare.03694 109828118 ppf: 983 ppct: 9 formats: fmt: @attributes: type: P tig: atl: The Dose-Response Relationship Between Body Mass Index and Mortality in Subjects Admitted to the ICU With and Without Mechanical Ventilation. aug: au: Yusuke Sasabuchi Hideo Yasunaga Hiroki Matsui Lefor, Alan T. Hiromasa Horiguchi Kiyohide Fushimi Masamitsu Sanui affil: Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo sug: subj: Body Mass Index Hospital Mortality Risk Factors Intensive Care Units Critically Ill Patients Respiration, Artificial Obesity Complications Human Japan Descriptive Statistics Chi Square Test Kruskal-Wallis Test Confidence Intervals Odds Ratio Data Analysis Software Logistic Regression Male Female Middle Age Aged Aged, 80 and Over Funding Source Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: BACKGROUND: Obesity has been associated with increased mortality in the general population, whereas a paradoxical relationship between higher body mass index and lower mortality has been referred to as the obesity paradox in critically ill patients. However, it remains unknown whether a particular subgroup is most affected. The aim of the present study is to elucidate whether obesity is associated with lower mortality in the ICU population by comparing subjects with and without mechanical ventilation. METHODS: A total of 334,238 subjects from a nationwide database who were discharged between July 2010 and March 2012 and who were admitted to general ICUs during their hospitalization were included in this study. The primary outcome was in-hospital mortality. RESULTS: Of all subjects evaluated, 23.3% were started on mechanical ventilation within the first 2 d after ICU admission. Compared with the non-ventilated group, the ventilated group was more likely to have sepsis, pneumonia, or coma. The ventilated group underwent more procedures within the first 2 d after ICU admission compared with the non-ventilated group. A restricted cubic spline function showed lower mortality in subjects with a higher body mass index among the ventilated group, whereas mortality was increased with increasing body mass index in the non-ventilated group. CONCLUSIONS: This study shows that a high body mass index is associated with low mortality in the mechanically ventilated group, whereas the non-ventilated group showed a reverse J-shaped association. There was a higher mortality rate in underweight subjects in both groups. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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