The DOI matches its Crossref record; 4 of the 4 references it cites were found in a registry or an index.
Body Mass Index Is Associated With Hospital Mortality in Critically Ill Patients: An Observational Cohort Study
Abstract
OBJECTIVE: Obesity is associated with a variety of diseases, which results in a decreased overall life expectancy. Nevertheless, some studies suggest that being overweight may reduce hospital mortality of certain patient groups, referred to as obesity paradox. Conflicting results for critically ill patients are reported. Therefore, we wished to investigate the association of body mass index and hospital mortality in critically ill patients. DESIGN: Observational cohort study in Dutch critically ill patients. SETTING: A dataset from the Dutch National Intensive Care Evaluation registry that includes patients admitted to Dutch ICUs was used. PATIENTS: One hundred fifty-four thousand three hundred and eight ICU patients of teaching and nonteaching units in urban and nonurban hospitals. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We used logistic regression analysis, correcting for case mix (Simplified Acute Physiology Score II, age, gender, admission type, neoplasm, AIDS, hematologic malignancy, immunologic insufficiency, mechanical ventilation, and calendar year), to determine the relationship between body mass index and hospital mortality. Body mass index was included in the model as a continuous nonlinear covariate in a restricted regression spline transformation. To facilitate interpretation, adjusted odds ratios were calculated for the World Health Organization-based body mass index classes. Body mass index was found to be significantly associated with hospital mortality, with risks quickly increasing for underweight patients (body mass index < 18.5 kg/m). Obese and seriously obese patients, with a body mass index of 30-39.9 kg/m, had the lowest risk of death with an adjusted odds ratio of 0.86 (0.83-0.90). CONCLUSIONS: This large observational database shows an inverse association between obesity and hospital mortality in critically ill patients that could not be explained by a variety of known confounders.
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Citations
Cites
Adipose tissue, adipokines, and inflammation
Fantuzzi, G. (2005) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2005.02.023 · Cited by 2,606 · cited 2×
“Several explanations have been put forward to explain the apparently beneficial effects of obesity on critically ill patients, including more nutritional reserves, higher levels of anti-inflammatory cytokines (9, 23), and the higher cholesterol and lipid levels common in obese patients, which bind endotoxin during cri…”
BackgroundGeneral and abdominal adiposity and risk of death in Europe
Pischon, T., Boeing, H., Hoffmann, K., Bergmann, M., Schulze, M. B., Overvad, K., van der Schouw, Y. T., Spencer, E., Moons, K. G. M., Tjønneland, A., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0801891 · Cited by 2,155
Fonarow, G. C., Srikanthan, P., Costanzo, M. R., Cintron, G. B., & Lopatin, M. (2007) · American Heart Journal · doi:10.1016/j.ahj.2006.09.007 · Cited by 512
Peek, N., Arts, D. G. T., Bosman, R. J., van der Voort, P. H. J., & de Keizer, N. F. (2007) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2006.08.011 · Cited by 92 · cited 1×
“We used the Simplified Acute Physiology Score (SAPS) II for casemix adjustment because this scoring system fits best with the patient population of the NICE registry (14).”
Method
Cited by
Weijs, P. J., Looijaard, W. G., Dekker, I. M., Stapel, S. N., Girbes, A. R., Straaten, H. M. O.-V., & Beishuizen, A. (2014) · Critical Care · doi:10.1186/cc13189 · Cited by 459
The obesity paradox in ICU patients
Pan, J., Shaffer, R., Sinno, Z., Tyler, M., & Ghosh, J. (2017) · 2017 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc.2017.8037576 · Cited by 20
Metadata
- Authors
- Pickkers, P., de Keizer, N., Dusseljee, J., Weerheijm, D., van der Hoeven, J. G., & Peek, N.
- Venue
- Critical Care Medicine
- Published
- 2013-08
- Volume
- 41
- Issue
- 8
- Pages
- 1878-1883
- ISSN
- 0090-3493 (ISSN-L)
- OpenAlex
- W1984330756
- Cited by
- 191
- References
- 4
- FWCI
- 20.19
- Type
- journal article
- Language
- en
- Open access
- closed
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- Pickkers, P., de Keizer, N., Dusseljee, J., Weerheijm, D., van der Hoeven, J. G., & Peek, N. (2013). Body Mass Index Is Associated With Hospital Mortality in Critically Ill Patients: An Observational Cohort Study. Critical Care Medicine. https://doi.org/10.1097/ccm.0b013e31828a2aa1
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