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Cited by 175Obesity, Physical Activity, DietSepsis Diagnosis and TreatmentClinical Nutrition and Gastroenterology

Influence of Overweight on ICU Mortality

Goulenok, Cyril, Monchi, Mehran, Chiche, Jean-Daniel, Mira, Jean-Paul, Dhainaut, Jean-François, Cariou, Alain·2004·Chest
DOI 10.1378/chest.125.4.1441
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Abstract

Study objective Overweight patients seem to have a poorer outcome and a higher risk of complications during their stay in the ICU. We conducted a prospective study in order to examine the relationship between body mass index (BMI) and mortality among these patients.Design Prospective clinical study.Setting A 24-bed medical ICU in a university-affiliated hospital.Methods All patients hospitalized in the ICU over a 1-year period were included except those dying or being discharged from the hospital within 24 h of admission. Overweight patients were defined as those having a BMI > 75th percentile of this selected ICU population. Other data collected were demographic and ICU-related data. The Mann-Whitney test was used to compare numeric data between groups (ie, obese and nonobese populations). Variables that were significantly associated with ICU mortality by univariate analysis were entered into a multiple logistic regression model, allowing the determination of independent predictors.Results Eight hundred thirteen patients were included in the study. The limit of the upper quartile of the BMI was 27. This value was used to separate obese (n = 215) and nonobese (n = 598) groups. Significant differences between obese and nonobese patients were observed in age, length of stay in the ICU, simplified acute physiology score (SAPS) II, and ICU mortality. The observed mortality of obese patients was significantly higher than that predicted by SAPS II (32% vs 18%, respectively; p = 0.001). No difference was observed in frequency of nosocomial infection or duration of mechanical ventilation for mortality in ICU patients. Using a multivariate analysis, the predictive factors of mortality were SAPS II (p < 0.0001) and BMI > 27 (p < 0.01).Conclusion This is the first prospective study showing high BMI value as an independent prognostic factor of mortality for ICU patients. The prognostic scoring systems currently in use, which were designed to predict the mortality of ICU patients, do not include BMI or do not consider obesity. These may underestimate, therefore, the risk for the specific population of obese patients.

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  • In previous studies, low recreational activity reported at follow-up was strongly associated with major weight gain (>13 kg over the preceding 10 years).

    “In previous studies 14 , low recreational activity reported at follow-up survey was strongly associated with major weight gain (. 13 kg over the preceding 10 years).”

    From Overweight and obesity in a Swiss city: 10-year trends (2007) · cites this paper as [14]

  • In long-term studies, weight gain has been associated with low physical activity levels.

    “In long-term studies, weight gain has been associated with low physical activity levels 14 .”

    From Overweight and obesity in a Swiss city: 10-year trends (2007) · cites this paper as [14]

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Authors
Goulenok, C., Monchi, M., Chiche, J.-D., Mira, J.-P., Dhainaut, J.-F., & Cariou, A.
Affiliations
  • Hôpital Cochin (FR)
  • Hôpital Privé Jacques Cartier (FR)
Corresponding author
Goulenok, Cyril
ORCID
Venue
Chest
Publisher
Elsevier BV
Published
2004-04
Volume
125
Issue
4
Pages
1441-1445
ISSN
0012-3692 (ISSN-L)
DOI
10.1378/chest.125.4.1441
OpenAlex
W2165271136
Cited by
175
References
31
Citations by year
2025: 1 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 6 · 2020: 6 · 2019: 6 · 2018: 5 · 2017: 6 · 2016: 8 · 2015: 11 · 2014: 8 · 2013: 9 · 2012: 7
FWCI
14.26
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • CHEST Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
Keywords
obesity, overweight, body mass index, ICU mortality, intensive care unit patients, prognostic factors, SAPS II, mortality prediction, nosocomial infections, mechanical ventilation
MeSH terms
Adult, Aged, Humans, Intensive Care Units, Male, Middle Aged, Mortality, Obesity, Prognosis, Prospective Studies, Risk Factors, Body Mass Index, Critical Illness

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