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2022, Number 2

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Med Crit 2022; 36 (2)

Obesity as a prognostic factor in the critical ill patients

Medina FJ, Hernández LS, Olavide AE, Salas DA

Language: Spanish
References: 15
Page: 98-100
PDF size: 181.12 Kb.


ABSTRACT

Introduction: Obesity is a disease with a negative impact on survival; the prognosis of these patients is has controversial results. The term "obesity paradox" refers as a protective effect on mortality. Objective: To determine whether obesity is a protective factor in the critically ill patient. Material y methods: A cohort study was conducted. Data was obtained from ICU records of the ISSSTE Monterrey Regional Hospital during 2018, bivariate analysis was performed for χ2 and Mann Whitney's U association, for Pearson's formula correlation and survival analysis with Kaplan-Meier curve. Results: 151 records of 73 obese and 78 non-obese patients were analyzed, it was observed that obesity is a protective factor for mortality (p = 0.044, OR 0.431(IC 0.187-0.992), BMI does not correlate with APACHE II (p = 0.066), however, an impact on the survival curve was observed (p = 0.42). Conclusions: According to the results obtained, it matches with the term "obesity paradox", however, its association with chronic degenerative diseases, prolonged stay in the ICU and its complications do not cease to have a negative impact on survival outside the unit.


REFERENCES

  1. Suárez-Carmona W, Sánchez-Oliver AJ, González-Jurado JA. Fisiopatología de la obesidad: perspectiva actual. Rev Chil Nutr. 2017;44:226-233.

  2. González Jiménez E. Obesidad: análisis etiopatogénico y fisiopatológico [10.1016/j.endonu.2012.03.006]. Endocrinología y Nutrición. 2013;60(1):17-24. doi: 10.1016/j.endonu.2012.03.006.

  3. Vásquez-Revilla HR, Revilla-Rodríguez E, Terrazas-Luna V. Mortalidad en el paciente críticamente enfermo con obesidad. Rev Asoc Mex Med Crít Ter Intensiva. 2015;29:93-98.

  4. Slynkova K, Mannino DM, Martin GS, Morehead RS, Doherty DE. The role of body mass index and diabetes in the development of acute organ failure and subsequent mortality in an observational cohort. Crit Care. 2006;10(5):R137. doi: 10.1186/cc5051.

  5. Dickerson RN. The obesity paradox in the ICU: real or not? Crit Care. 2013;17(3):154-154. doi: 10.1186/cc12715.

  6. Hogue CW Jr, Stearns JD, Colantuoni E, Robinson KA, Stierer T, Mitter N, et al. The impact of obesity on outcomes after critical illness: a meta-analysis. Intensive Care Med. 2009;35(7):1152-1170. doi: 10.1007/s00134-009-1424-5.

  7. Afessa B, Gajic O, Keegan MT. Severity of illness and organ failure assessment in adult intensive care units. Crit Care Clin. 2007;23(3):639-658. doi: 10.1016/j.ccc.2007.05.004.

  8. Vásquez-Revilla HR, Revilla-Rodríguez E. El tejido adiposo durante la enfermedad crítica y la paradoja de la obesidad. Med Crít (Col Mex Med Crít). 2017;31:36-41.

  9. Oliveros H, Villamor E. Obesity and mortality in critically ill adults: a systematic review and meta-analysis. Obesity (Silver Spring). 2008;16(3):515-521. doi: 10.1038/oby.2007.102.

  10. Arabi YM, Dara SI, Tamim HM, Rishu AH, Bouchama A, Khedr MK, et al. Clinical characteristics, sepsis interventions and outcomes in the obese patients with septic shock: an international multicenter cohort study. Crit Care. 2013;17(2):R72. doi: 10.1186/cc12680.

  11. Martino JL, Stapleton RD, Wang M, Day AG, Cahill NE, Dixon AE, et al. Extreme obesity and outcomes in critically ill patients. Chest. 2011;140(5):1198-1206. doi: 10.1378/chest.10-3023.

  12. Adams KF, Schatzkin A, Harris TB, Kipnis V, Mouw T, Ballard-Barbash R, et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med. 2006;355(8):763-778. doi: 10.1056/NEJMoa055643.

  13. Katzmarzyk PT, Janssen I, Ardern CI. Physical inactivity, excess adiposity and premature mortality. Obes Rev. 2003;4(4):257-290. doi: 10.1046/j.1467-789x.2003.00120.x.

  14. Manuel Moreno G. Definición y clasificación de la obesidad. Revista Médica Clínica Las Condes. 2012 2012/03/01/;23(2):124-128. doi: https://doi.org/10.1016/S0716-8640(12)70288-2.

  15. Abbate LM, Stevens J, Schwartz TA, Renner JB, Helmick CG, Jordan JM. Anthropometric measures, body composition, body fat distribution, and knee osteoarthritis in women. Obesity (Silver Spring). 2006;14(7):1274-1281. doi: 10.1038/oby.2006.145.




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