Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
The obesity paradox proposes that, in certain diseases, patients with obesity have lower mortality.
OBJECTIVE. To associate body mass index with 30-day mortality in adults with septic
shock. MATERIALS AND METHODS. Observational, analytical, retrospective, multicenter, retrospective
study. We analyzed 673 patients with septic shock, admitted to intensive care in
two hospitals in the city of Quito - Ecuador, during January 2017 - December 2019. Inclusion
criteria: older than 18 years, septic shock, weight, height and vital condition at day 30. Exclusion
criteria: Do not resuscitate order, pregnant women, organ donation protocol, palliative care. Variables
were collected from the digital and physical medical records of the participating centers.
Calculated risk estimates were presented as OR (Odds Ratio) in bivariate analysis and OR Adj
(adjusted OR) for multivariate analysis. A p value <0.05 was considered statistically significant.
All statistical analyses were performed using R® statistical software (Version 4.1.2). RESULTS.
The mean age was 65 years, mean body mass index 25.9 kg/m2 (+4.9 kg/m2). Body mass
index > 25 kg/m2 was 54.3%. Overall mortality was 49.2%. Overweight and obese subjects
had lower mortality, OR: 0.48 (95% CI: 0.34, 0.68; p<0.0001) and OR 0.45 (95 % CI: 0.28, 0.70;
p=0.001) respectively, with similar trend in multivariate analysis. Underweight subjects had the
highest mortality (OR: 2.12. 95% CI: 0.91 - 5.54. p: 0.097). DISCUSSION. The results obtained
support the obesity paradox theory, however, assessment according to obesity levels was not
performed. CONCLUSIONS. Mortality in septic shock is lower in overweight and obese subjects
compared to normal weight or underweight subjects.
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