tetano
Editor, Senior Moderator
Chest. 2010 Aug 5. [Epub ahead of print]
IMPACT OF OBESITY IN PATIENTS INFECTED WITH NEW INFLUENZA A (H1N1)v.
D?az E, Rodr?guez A, Martin-Loeches I, Lorente L, Del Mar Mart?n M, Pozo JC, Montejo JC, Estella A, Arenzana A, Rello J; H1N1 SEMICYUC Working Group.
(1)Critical Care Department, Hospital Universitario Joan XXIII- CIBER Enfermedades Respiratorias, URV, and IISPV Tarragona. Spain.
Abstract
Abstract OBJECTIVE: A large proportion of patients infected with new influenza A (H1N1) are obese. Obesity has been proposed as a risk factor influencing outcome in these patients. However, its role remains unclear. We evaluate the outcome of obese patients infected by new influenza A (H1N1)v in the ICU determining whether obesity is a risk factor for mortality. DESIGN: Prospective, observational and multicenter study performed in 144 ICU. Data were obtained from the GTEI/SEMICYUC registry. PATIENTS: Adult patients with influenza A (H1N1) confirmed by rt-PCR were included in the analysis. Obese (BMI>30) were compared with non-obese patients. Cox regression analysis was used to determine adjusted mortality. Differences of p <0.05 were considered significant. MEASUREMENTS AND RESULTS: In January 2010, the GTEI/SEMICYUC registry had complete records for 416 patients. One hundred and fifty patients (36.1%) were obese, of whom 67 (44.7%) were morbidly obese (BMI >40). MV was more frequently applied in obese patients (64 % vs 52.4% p<0.01) Patients with obesity remained longer on MV than non-obese patients (6.5+/-10.3 vs 9.3+/-9.7 days, p=0.02), had longer ICU LOS (10.8+/-12.1 vs 13.7+/-11.7 days; p=0.03), and longer hospitalization (18.2+/-14.6 vs 22.2+/-16.5 days; p=0.02). Mortality adjusted by severity and potential confounders identified that obesity was not significantly associated with ICU mortality [HR 1.1 (95% CI 0.69-1.75), p = 0.68]. CONCLUSION: In our cohort, obese infected with the novel influenza A (H1N1)v did not have increased mortality. However, there was an association between obesity and higher ICU resource consumption.
PMID: 20688928 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20688928
IMPACT OF OBESITY IN PATIENTS INFECTED WITH NEW INFLUENZA A (H1N1)v.
D?az E, Rodr?guez A, Martin-Loeches I, Lorente L, Del Mar Mart?n M, Pozo JC, Montejo JC, Estella A, Arenzana A, Rello J; H1N1 SEMICYUC Working Group.
(1)Critical Care Department, Hospital Universitario Joan XXIII- CIBER Enfermedades Respiratorias, URV, and IISPV Tarragona. Spain.
Abstract
Abstract OBJECTIVE: A large proportion of patients infected with new influenza A (H1N1) are obese. Obesity has been proposed as a risk factor influencing outcome in these patients. However, its role remains unclear. We evaluate the outcome of obese patients infected by new influenza A (H1N1)v in the ICU determining whether obesity is a risk factor for mortality. DESIGN: Prospective, observational and multicenter study performed in 144 ICU. Data were obtained from the GTEI/SEMICYUC registry. PATIENTS: Adult patients with influenza A (H1N1) confirmed by rt-PCR were included in the analysis. Obese (BMI>30) were compared with non-obese patients. Cox regression analysis was used to determine adjusted mortality. Differences of p <0.05 were considered significant. MEASUREMENTS AND RESULTS: In January 2010, the GTEI/SEMICYUC registry had complete records for 416 patients. One hundred and fifty patients (36.1%) were obese, of whom 67 (44.7%) were morbidly obese (BMI >40). MV was more frequently applied in obese patients (64 % vs 52.4% p<0.01) Patients with obesity remained longer on MV than non-obese patients (6.5+/-10.3 vs 9.3+/-9.7 days, p=0.02), had longer ICU LOS (10.8+/-12.1 vs 13.7+/-11.7 days; p=0.03), and longer hospitalization (18.2+/-14.6 vs 22.2+/-16.5 days; p=0.02). Mortality adjusted by severity and potential confounders identified that obesity was not significantly associated with ICU mortality [HR 1.1 (95% CI 0.69-1.75), p = 0.68]. CONCLUSION: In our cohort, obese infected with the novel influenza A (H1N1)v did not have increased mortality. However, there was an association between obesity and higher ICU resource consumption.
PMID: 20688928 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20688928