Sepsis and the Obesity Paradox: Size Matters in More Than One Way

Objectives: Multiple studies have demonstrated an obesity paradox such that obese ICU patients have lower mortality and better outcomes. We conducted this study to determine if the mortality benefit conferred by obesity is affected by baseline serum lactate and mean arterial pressure. Design(s): Retrospective analysis of prospectively collected clinical data. Setting(s): Five community-based and one academic medical center in the Omaha, NE. Patient(s): 7,967 adults hospitalized with sepsis. Intervention(s): None. Measurements and Main Results: Patients were categorized by body mass index as underweight, normal weight, overweight, or obese. Multivariable logistic regression models were used to estimate the odds of in-hospital death by body mass index category; two-way interactions between body mass index and each covariate were also evaluated. Subgroup and sensitivity analyses were conducted using an ICU cohort and Acute Physiology and Chronic Health Evaluation III scores, respectively. The overall unadjusted mortality rate was 12.1% and was consistently lower in higher body mass index categories (all comparisons, p
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news