title: Obesity is associated with increased morbidity but not mortality in critically ill patients.
abstract: OBJECTIVE
  To investigate the possible impact of obesity on morbidity and mortality in intensive care unit (ICU) patients included in the European observational sepsis occurrence in acutely ill patients (SOAP) study.
  
  
  METHODS
  Planned substudy from the SOAP database.
  
  
  METHODS
  One hundred and ninety-eight ICUs in 24 European countries.
  
  
  METHODS
  All patients admitted to one of the participating ICUs. Patients were classified, according to their body mass index (BMI), as underweight (<18.5 kg/m(2)), normal weight (18.5-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), obese (30-39.9 kg/m(2)), and very obese (>or=40 kg/m(2)).
  
  
  RESULTS
  The BMI was available in 2,878 (91%) of the 3,147 patients included in the SOAP study; 120 patients (4.2%) were underweight, 1,206 (41.9%) had a normal BMI, 1,047 (36.4%) were overweight, 424 (14.7%) were obese, and 81 (2.8%) were very obese. Obese and very obese patients more frequently developed ICU-acquired infections than patients in lower BMI categories. Very obese patients showed a trend towards longer ICU [median (IQ): 4.1 (1.8-12.1) vs. 3.1 (1.7-7.2) days, P = 0.056) and hospital lengths of stay [14.3 (8.4-27.4) vs. 12.3 (5.1-24.4), days P = 0.077] compared to those with a normal BMI. However, there were no significant differences among the groups in ICU or hospital mortality rates. In a multivariate Cox regression analysis, none of the BMI categories was associated with an increased risk of 60-day in-hospital death.
  
  
  CONCLUSIONS
  BMI did not have a significant impact on mortality in this mixed population of ICU patients.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Friedrich-Schiller-University Jena, Jena, Germany.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Sakr
authors.forename: Christian
authors.initials: C
authors.lastname: Madl
authors.forename: Daniela
authors.initials: D
authors.lastname: Filipescu
authors.forename: Rui
authors.initials: R
authors.lastname: Moreno
authors.forename: Johan
authors.initials: J
authors.lastname: Groeneveld
authors.forename: Antonio
authors.initials: A
authors.lastname: Artigas
authors.forename: Konrad
authors.initials: K
authors.lastname: Reinhart
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
mesh_terms: D015992:Body Mass Index; D016009:Chi-Square Distribution; D016638:Critical Illness / Q000401:mortality; D003428:Cross Infection / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000401:mortality; D016016:Proportional Hazards Models; D018805:Sepsis / Q000150:complications* / Q000401:mortality; D018709:Statistics, Nonparametric