Dataset Information

Impact of body mass index on survival of medical patients with sepsis: a prospective cohort study in a university hospital in China.

ABSTRACT:

Objective

To evaluate the impact of body mass index (BMI) on survival of a Chinese cohort of medical patients with sepsis.

Design

A single-centre prospective cohort study conducted from May 2015 to April 2017.

Setting

A tertiary care university hospital in China.

Participants

A total of 178 patients with sepsis admitted to the medical intensive care unit (ICU) were included.

Main outcome measures

The primary outcome was 90-day mortality while the secondary outcomes were in-hospital mortality, length of ICU stay and length of hospital stay.

Results

The median age (IQR) was 78 (66-84) years old, and 77.0% patients were older than 65 years. The 90-day mortality was 47.2%. The in-hospital mortality was 41.6%, and the length of ICU stay and hospital stay were 12 (5-22) and 15 (9-28) days, respectively. Cox proportional hazard regression analysis identified that Sequential Organ Failure Assessment score (HR=1.229, p<0.001), Acute Physiology and Chronic Health Evaluation II score (HR=1.050, p<0.001) and BMI (HR=0.940, p=0.029) were all independently associated with the 90-day mortality. Patients were divided into four groups based on BMI (underweight 33 (18.5%), normal 98 (55.1%), overweight 36 (20.2%) and obese 11 (6.2%)). The 90-day mortality (66.7%, 48.0%, 36.1% and 18.2%, p=0.015) and in-hospital mortality (60.6%, 41.8%, 30.6% and 18.2%, p=0.027) were statistically different among the four groups. Differences in survival among the four groups were demonstrated by Kaplan-Meier survival analysis (p=0.008), with the underweight patients showing a lower survival rate.

Conclusions

BMI was an independent factor associated with 90-day survival in a Chinese cohort of medical patients with sepsis, with patients having a lower BMI at a higher risk of death.

SUBMITTER: Zhou Q

PROVIDER: S-EPMC6144486 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Publications

Impact of body mass index on survival of medical patients with sepsis: a prospective cohort study in a university hospital in China.

Zhou Qingtao Q Wang Meng M Li Shuo S Zhang Jing J Ma Qingbian Q Ding Yanling Y Ge Hongxia H Shen Ning N Zheng Yaan Y Sun Yongchang Y

BMJ open 20180912 9

<h4>Objective</h4>To evaluate the impact of body mass index (BMI) on survival of a Chinese cohort of medical patients with sepsis.<h4>Design</h4>A single-centre prospective cohort study conducted from May 2015 to April 2017.<h4>Setting</h4>A tertiary care university hospital in China.<h4>Participants</h4>A total of 178 patients with sepsis admitted to the medical intensive care unit (ICU) were included.<h4>Main outcome measures</h4>The primary outcome was 90-day mortality while the secondary out ...[more]

PMID: 30209156

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Project description:BackgroundExcess weight is associated with poor health and increased health-care costs. However, a detailed understanding of the effects of excess weight on total hospital costs and costs for different health conditions is needed.MethodsWomen in England aged 50-64 years were recruited into the prospective Million Women Study cohort in 1996-2001 through 60 NHS breast cancer screening centres. Participants were followed up and annual hospital costs and admission rates were estimated for April 1, 2006, to March 31, 2011, in relation to body-mass index (BMI) at recruitment, overall and for categories of health conditions defined by the International Classification of Diseases 10th revision chapter of the primary diagnosis at admission. Associations of BMI with hospital costs were projected to the 2013 population of women aged 55-79 years in England.Findings1 093 866 women who provided information on height and weight, had a BMI of at least 18·5 kg/m2, and had no previous cancer at recruitment, were followed up for an average of 4·9 years from April 1, 2006 (12·3 years from recruitment), during which time 1·84 million hospital admissions were recorded. Annual hospital costs were lowest for women with a BMI of 20·0 kg/m2 to less than 22·5 kg/m2 (£567 per woman per year, 99% CI 556-577). Every 2 kg/m2 increase in BMI above 20 kg/m2 was associated with a 7·4% (7·1-7·6) increase in annual hospital costs. Excess weight was associated with increased costs for all diagnostic categories, except respiratory conditions and fractures. £662 million (14·6%) of the estimated £4·5 billion of total annual hospital costs among all women aged 55-79 years in England was attributed to excess weight (BMI ≥25 kg/m2), of which £517 million (78%) arose from hospital admissions with procedures. £258 million (39%) of the costs attributed to excess weight were due to musculoskeletal admissions, mainly for knee replacement surgeries.InterpretationExcess body weight is associated with increased hospital costs for middle-aged and older women in England across a broad range of conditions, especially knee replacement surgery and diabetes. These results provide reliable up-to-date estimates of the health-care costs of excess weight and emphasise the need for investment to tackle this public health issue.FundingCancer Research UK; Medical Research Council; National Institute for Health Research.

Dataset Information

Impact of body mass index on survival of medical patients with sepsis: a prospective cohort study in a university hospital in China.

Objective

Design

Setting

Participants

Main outcome measures

Results

Conclusions

Publications

Impact of body mass index on survival of medical patients with sepsis: a prospective cohort study in a university hospital in China.

Similar Datasets

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