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Association between body mass index and short-term mortality in patients with intra-abdominal infections: a retrospective, single-centre cohort study using the Medical Information Mart for Intensive Care database
OBJECTIVES: This study aimed to determine the relationship between the body mass index (BMI) and short-term mortality of patients with intra-abdominal infection (IAI) using the Medical Information Mart for Intensive Care (MIMIC-III) database. DESIGN: Retrospective cohort study. SETTING: Adult intens...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8365805/ https://www.ncbi.nlm.nih.gov/pubmed/34389563 http://dx.doi.org/10.1136/bmjopen-2020-046623 |
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author | Li, Qinglin Tong, Yingmu Liu, Sinan Yang, Kaibo Liu, Chang Zhang, Jingyao |
author_facet | Li, Qinglin Tong, Yingmu Liu, Sinan Yang, Kaibo Liu, Chang Zhang, Jingyao |
author_sort | Li, Qinglin |
collection | PubMed |
description | OBJECTIVES: This study aimed to determine the relationship between the body mass index (BMI) and short-term mortality of patients with intra-abdominal infection (IAI) using the Medical Information Mart for Intensive Care (MIMIC-III) database. DESIGN: Retrospective cohort study. SETTING: Adult intensive care units (ICUs) at a tertiary hospital in the USA. PARTICIPANTS: Adult IAI ICU patients from 2001 to 2012 in the MIMIC-III database. INTERVENTIONS: In univariate analysis, we compared the differences in the characteristics of patients in each BMI group. Cox regression models were used to evaluate the relationships between BMI and short-term prognosis. PRIMARY AND SECONDARY OUTCOME MEASURES: 90-day survival. RESULTS: In total, 1161 patients with IAI were included. There were 399 (34.4%) patients with a normal BMI (<25 kg/m(2)), 357 (30.8%) overweight patients (25–30 kg/m(2)) and 405 (34.9%) obese patients (>30 kg/m(2)) who tended to be younger (p<0.001) and had higher Sequential Organ Failure Assessment scores (p<0.05). The mortality of obese patients at 90 days was lower than that of patients with a normal BMI (20.74% vs 23.25%, p<0.05), but their length of stay in the ICU was higher (4.9 days vs 3.6 days, p<0.001); however, their rate of mechanical ventilation utilisation was higher (61.48% vs 56.86%, p<0.05). In the Cox regression model, we also confirmed that BMI was a protective factor in patients with IAIs, and the adjusted mortality rate of patients with a higher BMI was 0.97 times lower than that of patients with a lower BMI (p<0.001, HR=0.97, 95% CI 0.96 to 0.99). CONCLUSIONS: IAI patients with an overweight or obese status might have lower 90-day mortality than patients with a normal BMI. |
format | Online Article Text |
id | pubmed-8365805 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-83658052021-08-30 Association between body mass index and short-term mortality in patients with intra-abdominal infections: a retrospective, single-centre cohort study using the Medical Information Mart for Intensive Care database Li, Qinglin Tong, Yingmu Liu, Sinan Yang, Kaibo Liu, Chang Zhang, Jingyao BMJ Open Intensive Care OBJECTIVES: This study aimed to determine the relationship between the body mass index (BMI) and short-term mortality of patients with intra-abdominal infection (IAI) using the Medical Information Mart for Intensive Care (MIMIC-III) database. DESIGN: Retrospective cohort study. SETTING: Adult intensive care units (ICUs) at a tertiary hospital in the USA. PARTICIPANTS: Adult IAI ICU patients from 2001 to 2012 in the MIMIC-III database. INTERVENTIONS: In univariate analysis, we compared the differences in the characteristics of patients in each BMI group. Cox regression models were used to evaluate the relationships between BMI and short-term prognosis. PRIMARY AND SECONDARY OUTCOME MEASURES: 90-day survival. RESULTS: In total, 1161 patients with IAI were included. There were 399 (34.4%) patients with a normal BMI (<25 kg/m(2)), 357 (30.8%) overweight patients (25–30 kg/m(2)) and 405 (34.9%) obese patients (>30 kg/m(2)) who tended to be younger (p<0.001) and had higher Sequential Organ Failure Assessment scores (p<0.05). The mortality of obese patients at 90 days was lower than that of patients with a normal BMI (20.74% vs 23.25%, p<0.05), but their length of stay in the ICU was higher (4.9 days vs 3.6 days, p<0.001); however, their rate of mechanical ventilation utilisation was higher (61.48% vs 56.86%, p<0.05). In the Cox regression model, we also confirmed that BMI was a protective factor in patients with IAIs, and the adjusted mortality rate of patients with a higher BMI was 0.97 times lower than that of patients with a lower BMI (p<0.001, HR=0.97, 95% CI 0.96 to 0.99). CONCLUSIONS: IAI patients with an overweight or obese status might have lower 90-day mortality than patients with a normal BMI. BMJ Publishing Group 2021-08-13 /pmc/articles/PMC8365805/ /pubmed/34389563 http://dx.doi.org/10.1136/bmjopen-2020-046623 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Intensive Care Li, Qinglin Tong, Yingmu Liu, Sinan Yang, Kaibo Liu, Chang Zhang, Jingyao Association between body mass index and short-term mortality in patients with intra-abdominal infections: a retrospective, single-centre cohort study using the Medical Information Mart for Intensive Care database |
title | Association between body mass index and short-term mortality in patients with intra-abdominal infections: a retrospective, single-centre cohort study using the Medical Information Mart for Intensive Care database |
title_full | Association between body mass index and short-term mortality in patients with intra-abdominal infections: a retrospective, single-centre cohort study using the Medical Information Mart for Intensive Care database |
title_fullStr | Association between body mass index and short-term mortality in patients with intra-abdominal infections: a retrospective, single-centre cohort study using the Medical Information Mart for Intensive Care database |
title_full_unstemmed | Association between body mass index and short-term mortality in patients with intra-abdominal infections: a retrospective, single-centre cohort study using the Medical Information Mart for Intensive Care database |
title_short | Association between body mass index and short-term mortality in patients with intra-abdominal infections: a retrospective, single-centre cohort study using the Medical Information Mart for Intensive Care database |
title_sort | association between body mass index and short-term mortality in patients with intra-abdominal infections: a retrospective, single-centre cohort study using the medical information mart for intensive care database |
topic | Intensive Care |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8365805/ https://www.ncbi.nlm.nih.gov/pubmed/34389563 http://dx.doi.org/10.1136/bmjopen-2020-046623 |
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