The role of increased body mass index in outcomes of sepsis: a systematic review and meta-analysis
Abstract Background The role of increased body mass index (BMI) in sepsis is controversial. We aimed to evaluate the associations between overweight (25 kg/m2 < BMI ≤ 29.9 kg/m2), obese (30 kg/m2 < BMI ≤ 39.9 kg/m2) and morbidly obese (BMI > 40 kg/m2) BMIs and outcomes in septic patients. M...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-08-01
|
| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12871-017-0405-4 |
| _version_ | 1819230933654437888 |
|---|---|
| author | Sicong Wang Xu Liu Qixing Chen Can Liu Changshun Huang Xiangming Fang |
| author_facet | Sicong Wang Xu Liu Qixing Chen Can Liu Changshun Huang Xiangming Fang |
| author_sort | Sicong Wang |
| collection | DOAJ |
| description | Abstract Background The role of increased body mass index (BMI) in sepsis is controversial. We aimed to evaluate the associations between overweight (25 kg/m2 < BMI ≤ 29.9 kg/m2), obese (30 kg/m2 < BMI ≤ 39.9 kg/m2) and morbidly obese (BMI > 40 kg/m2) BMIs and outcomes in septic patients. Methods We searched the PubMed, Embase, Web of Science, Cochrane Library and ClinicalTrials.gov databases for studies published by December 1, 2016. Electronic database searches yielded 3713 articles, eight of which were included in this meta-analysis. Data were independently extracted by two reviewers, and a third reviewer participated in making decisions as needed. We used Review Manager to conduct the analysis, and the outcomes were reported with odds ratios (ORs) or mean differences (MDs). The primary outcome was mortality, and the secondary outcome was length of stay (LOS) in the intensive care unit (ICU) or the hospital. Results Data from eight studies involving a total of 9696 patients were pooled in our final analysis. Compared with patients with normal BMI (18.5 kg/m2 < BMI ≤ 24.9 kg/m2), patients with BMI ≥ 25 kg/m2 exhibited decreased mortality (OR 0.81; 95% confidence interval (CI), 0.74–0.89, P < 0.0001). In subgroup analysis, compared with normal-weight patients, overweight patients had lower mortality (OR 0.87; 95% CI 0.77–0.97, P = 0.02), whereas obese (OR 0.89, 95% CI 0.72–1.10, P = 0.29) and morbidly obese (OR 0.64, 95% CI 0.38–1.08, P = 0.09) patients did not exhibit significantly reduced mortality. Conclusions In sepsis cases, overweight, but not obesity or morbid obesity, was associated with lower mortality. Further prospective studies are needed to clarify this relationship. |
| first_indexed | 2024-12-23T11:36:57Z |
| format | Article |
| id | doaj.art-2900615a5abc4420933450874bc8fcfe |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-23T11:36:57Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-2900615a5abc4420933450874bc8fcfe2022-12-21T17:48:38ZengBMCBMC Anesthesiology1471-22532017-08-0117111110.1186/s12871-017-0405-4The role of increased body mass index in outcomes of sepsis: a systematic review and meta-analysisSicong Wang0Xu Liu1Qixing Chen2Can Liu3Changshun Huang4Xiangming Fang5Department of Anesthesiology and Intensive Care Medicine, the First Affiliated Hospital of Zhejiang University School of MedicineDepartment of Intensive Care Medicine, the Affiliated Hospital of Guizhou Medical UniversityClinical Research Center, Children’s Hospital, School of Medicine, Zhejiang UniversityDepartment of Anesthesiology and Intensive Care Medicine, the First Affiliated Hospital of Zhejiang University School of MedicineDepartment of Anesthesia, Ningbo First HospitalDepartment of Anesthesiology and Intensive Care Medicine, the First Affiliated Hospital of Zhejiang University School of MedicineAbstract Background The role of increased body mass index (BMI) in sepsis is controversial. We aimed to evaluate the associations between overweight (25 kg/m2 < BMI ≤ 29.9 kg/m2), obese (30 kg/m2 < BMI ≤ 39.9 kg/m2) and morbidly obese (BMI > 40 kg/m2) BMIs and outcomes in septic patients. Methods We searched the PubMed, Embase, Web of Science, Cochrane Library and ClinicalTrials.gov databases for studies published by December 1, 2016. Electronic database searches yielded 3713 articles, eight of which were included in this meta-analysis. Data were independently extracted by two reviewers, and a third reviewer participated in making decisions as needed. We used Review Manager to conduct the analysis, and the outcomes were reported with odds ratios (ORs) or mean differences (MDs). The primary outcome was mortality, and the secondary outcome was length of stay (LOS) in the intensive care unit (ICU) or the hospital. Results Data from eight studies involving a total of 9696 patients were pooled in our final analysis. Compared with patients with normal BMI (18.5 kg/m2 < BMI ≤ 24.9 kg/m2), patients with BMI ≥ 25 kg/m2 exhibited decreased mortality (OR 0.81; 95% confidence interval (CI), 0.74–0.89, P < 0.0001). In subgroup analysis, compared with normal-weight patients, overweight patients had lower mortality (OR 0.87; 95% CI 0.77–0.97, P = 0.02), whereas obese (OR 0.89, 95% CI 0.72–1.10, P = 0.29) and morbidly obese (OR 0.64, 95% CI 0.38–1.08, P = 0.09) patients did not exhibit significantly reduced mortality. Conclusions In sepsis cases, overweight, but not obesity or morbid obesity, was associated with lower mortality. Further prospective studies are needed to clarify this relationship.http://link.springer.com/article/10.1186/s12871-017-0405-4SepsisBody mass indexObesityMortalityLength of stay |
| spellingShingle | Sicong Wang Xu Liu Qixing Chen Can Liu Changshun Huang Xiangming Fang The role of increased body mass index in outcomes of sepsis: a systematic review and meta-analysis BMC Anesthesiology Sepsis Body mass index Obesity Mortality Length of stay |
| title | The role of increased body mass index in outcomes of sepsis: a systematic review and meta-analysis |
| title_full | The role of increased body mass index in outcomes of sepsis: a systematic review and meta-analysis |
| title_fullStr | The role of increased body mass index in outcomes of sepsis: a systematic review and meta-analysis |
| title_full_unstemmed | The role of increased body mass index in outcomes of sepsis: a systematic review and meta-analysis |
| title_short | The role of increased body mass index in outcomes of sepsis: a systematic review and meta-analysis |
| title_sort | role of increased body mass index in outcomes of sepsis a systematic review and meta analysis |
| topic | Sepsis Body mass index Obesity Mortality Length of stay |
| url | http://link.springer.com/article/10.1186/s12871-017-0405-4 |
| work_keys_str_mv | AT sicongwang theroleofincreasedbodymassindexinoutcomesofsepsisasystematicreviewandmetaanalysis AT xuliu theroleofincreasedbodymassindexinoutcomesofsepsisasystematicreviewandmetaanalysis AT qixingchen theroleofincreasedbodymassindexinoutcomesofsepsisasystematicreviewandmetaanalysis AT canliu theroleofincreasedbodymassindexinoutcomesofsepsisasystematicreviewandmetaanalysis AT changshunhuang theroleofincreasedbodymassindexinoutcomesofsepsisasystematicreviewandmetaanalysis AT xiangmingfang theroleofincreasedbodymassindexinoutcomesofsepsisasystematicreviewandmetaanalysis AT sicongwang roleofincreasedbodymassindexinoutcomesofsepsisasystematicreviewandmetaanalysis AT xuliu roleofincreasedbodymassindexinoutcomesofsepsisasystematicreviewandmetaanalysis AT qixingchen roleofincreasedbodymassindexinoutcomesofsepsisasystematicreviewandmetaanalysis AT canliu roleofincreasedbodymassindexinoutcomesofsepsisasystematicreviewandmetaanalysis AT changshunhuang roleofincreasedbodymassindexinoutcomesofsepsisasystematicreviewandmetaanalysis AT xiangmingfang roleofincreasedbodymassindexinoutcomesofsepsisasystematicreviewandmetaanalysis |