The effect of obesity on clinical outcomes in presumed sepsis: a retrospective cohort study.
Sepsis is a major cause of hospital admissions and mortality. Nevertheless, there are significant gaps in our knowledge of the epidemiology of sepsis in obese people, who now represent more than one-third of the population in the United States. The objective of this study was to measure the association between obesity and mortality from presumed sepsis. A retrospective cohort study was used of 1,779 adult inpatients with presumed sepsis at a Tertiary Care Academic Institution from March 1, 2007 to June 30, 2011. Cases of sepsis were identified using a standardized algorithm for sepsis antibiotic treatment. Exposure (i.e., obesity) was defined as a body mass index ≥30 kg/m(2). Multivariable logistic regression was used to assess the adjusted association between obesity and mortality. Patients with presumed sepsis were of a median age of 60.9 years (interquartile range 49.7-71) and 41.1 % were women. A total of 393 patients died, resulting in a 28-day in-hospital mortality of 22.1 %. In adjusted analysis, obesity was not significantly associated with increased mortality (odds ratio 1.11, 95 % CI 0.85-1.41, P = 0.47). There was also no difference in the in-hospital length of stay (P = 0.45) or maximum percent change in serum creatinine (P = 0.32) between obese and non-obese patients. Finally, there was no difference in the proportion of initial inadequate vancomycin levels (P = 0.1) after presumed sepsis. Obesity was not associated with increased mortality in patients with presumed sepsis. Further research is needed to determine how excess adiposity modulates inflammation from sepsis.
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, CWN-L 1, Rm L111, 75 Francis Street, Boston, MA, 02115, USA, tgaulton@partners.org.
Timothy Glen
TG
Gaulton
Mark Gordon
MG
Weiner
Knashawn Hodge
KH
Morales
David Foster
DF
Gaieski
Jimish
J
Mehta
Ebbing
E
Lautenbach
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications* / Q000188:drug therapy / Q000401:mortality*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents