Body Mass Index and Mortality in Subjects With ARDS: Post-hoc Analysis of the OSCILLATE Trial.
BACKGROUND: Studies on the association of obesity with mortality in subjects with ARDS have yielded inconsistent results. METHODS: In a sub-analysis of the Oscillation for ARDS Treated Early (OSCILLATE) randomized controlled trial, 451 subjects were divided into 5 strata based on their body mass ind...
| Publicado en: | Respiratory Care Vol. 64; no. 9; pp. 1042 - 1049 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | CEU research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Sep2019
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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=138349772&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 138349772 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Sep2019 vid: 64 iid: 9 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 138349772 138349772 138349772 10.4187/respcare.06675 138349772 ppf: 1042 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Body Mass Index and Mortality in Subjects With ARDS: Post-hoc Analysis of the OSCILLATE Trial. aug: au: Tlayjeh, Haytham Arabi, Yaseen M. Ferguson, Niall D. Qi Zhou Lamontagne, Francois Arroliga, Alejandro Danesh, Valerie Dominguez-Cherit, Guillermo Jimenez, Edgar Mullaly, Adam Staub, Brandon Meade, Maureen O. affil: Intensive Care Department, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia sug: subj: Body Mass Index Adverse Effects Respiratory Distress Syndrome, Acute Mortality Hospital Mortality Risk Factors Human Secondary Analysis Education, Continuing (Credit) Post Hoc Analysis Multivariate Statistics Logistic Regression Odds Ratio Confidence Intervals Descriptive Statistics Analgesia Fentanyl Administration and Dosage Midazolam Administration and Dosage Chi Square Test Analysis of Variance Data Analysis Software Risk Assessment Outcomes (Health Care) Adult Middle Age Aged Male Female APACHE (Acute Physiology and Chronic Health Evaluation) Scales Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: BACKGROUND: Studies on the association of obesity with mortality in subjects with ARDS have yielded inconsistent results. METHODS: In a sub-analysis of the Oscillation for ARDS Treated Early (OSCILLATE) randomized controlled trial, 451 subjects were divided into 5 strata based on their body mass index (BMI) using the World Health Organization definitions: underweight < 18.5 kg/m²; normal weight 18.5-24.99 kg/m²; overweight 25-29.99 kg/m²; obese 30-39.99 kg/m²; severely obese>40 kg/m². The primary outcome was all-cause hospital mortality across BMI strata for all subjects and for the 2 study arms (high-frequency oscillatory ventilation [HFOV] vs conventional ventilation) separately using multivariable logistic regression adjusting for potential confounding variables. RESULTS: Hospital mortality was not different across the BMI strata for all subjects (P = .86), for the HFOV arm (P = .94) or for the conventional ventilation arm (P = .59). After risk adjustment, BMI was not associated with increased risk for hospital mortality (odds ratio 1.01, 95% CI 0.97-1.04, P = .67), whereas HFOV was independently associated with increased mortality (odds ratio 1.74, 95% CI 1.11-2.72, P = .02) with no effect modification by BMI strata (for this interaction, P = .56). Although there was no difference in the use of rescue therapies or in the number of days on sedation or analgesia, higher daily doses of fentanyl and midazolam were administered as BMI increased. CONCLUSION: There was no difference in adjusted hospital mortality across BMI strata in subjects with moderate to severe ARDS. Processes of care were not different across BMI strata except for higher daily doses of fentanyl as BMI increased. (ClinicalTrials.gov registration NCT0150640) pubtype: Academic Journal doctype: CEU research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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