title: Being overweight or obese is associated with decreased mortality in critically ill patients: a retrospective analysis of a large regional Italian multicenter cohort.
abstract: OBJECTIVE
  To describe the epidemiology of obesity in a large cohort of intensive care unit (ICU) patients and study its impact on outcomes.
  
  
  METHODS
  All 3902 patients admitted to one of 24 ICUs in the Piedmont region of Italy from April 3 to September 29, 2006, were included in this retrospective analysis of data from a prospective, multicenter study.
  
  
  RESULTS
  Mean body mass index (BMI) was 26.0 ± 5.4 kg/m(2): 32.8% of patients had a normal BMI, 2.6% were underweight, 45.1% overweight, 16.5% obese, and 2.9% morbidly obese. ICU mortality was significantly (P < .05) lower in overweight (18.8%) and obese (17.5%) patients than in those of normal BMI (22%). In multivariate logistic regression analysis, being overweight (OR = 0.73; 95%CI: 0.58-0.91, P = .007) or obese (OR = 0.62; 95%CI: 50.45-0.85, P = .003) was associated with a reduced risk of ICU death. Being morbidly obese was independently associated with an increased risk of death in elective surgery patients whereas being underweight was independently associated with an increased risk of death in patients admitted for short-term monitoring and after elective surgery.
  
  
  CONCLUSIONS
  In this cohort, overweight and obese patients had a reduced risk of ICU death. Being underweight or morbidly obese was associated with an increased risk of death in some subgroups of patients.
authors.affiliation: Department of Anesthesiology and Intensive Care, Friedrich-Schiller-University, Erlanger Allee 103, 07743 Jena, Germany. yasser.sakr@med.uni-jena.de
authors.forename: Yasser
authors.initials: Y
authors.lastname: Sakr
authors.forename: Cristina
authors.initials: C
authors.lastname: Elia
authors.forename: Luciana
authors.initials: L
authors.lastname: Mascia
authors.forename: Bruno
authors.initials: B
authors.lastname: Barberis
authors.forename: Silvano
authors.initials: S
authors.lastname: Cardellino
authors.forename: Sergio
authors.initials: S
authors.lastname: Livigni
authors.forename: Gilberto
authors.initials: G
authors.lastname: Fiore
authors.forename: Claudia
authors.initials: C
authors.lastname: Filippini
authors.forename: V Marco
authors.initials: VM
authors.lastname: Ranieri
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015897:Comorbidity; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009765:Obesity / Q000453:epidemiology / Q000401:mortality; D050177:Overweight / Q000453:epidemiology / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology / Q000401:mortality*; D012737:Sex Factors; D013851:Thinness / Q000453:epidemiology / Q000401:mortality