Favorable 90-Day Mortality in Obese Caucasian Patients with Septic Shock According to the Sepsis-3 Definition

• Published in: Journal of clinical medicine Vol. 9; no. 1; p. 46
• Main Authors: Mewes, Caspar, Böhnke, Carolin, Alexander, Tessa, Büttner, Benedikt, Hinz, José, Popov, Aron-Frederik, Ghadimi, Michael, Beißbarth, Tim, Raddatz, Dirk, Meissner, Konrad, Quintel, Michael, Bergmann, Ingo, Mansur, Ashham
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 24-12-2019; MDPI
• Subjects: Cancer therapies; Chronic obstructive pulmonary disease; Clinical medicine; Diabetes; Hypertension; Hypotension; Intensive care; Mortality; Obesity; Patients; Renal replacement therapy; Sepsis; Software; Survival analysis; White people; United States > US; Germany; Survival predictors; Sepsis-3 definition; 90-day mortality; septic shock; risk stratification; obesity
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm9010046

Septic shock is a frequent life-threatening condition and a leading cause of mortality in intensive care units (ICUs). Previous investigations have reported a potentially protective effect of obesity in septic shock patients. However, prior results have been inconsistent, focused on short-term in-hospital mortality and inadequately adjusted for confounders, and they have rarely applied the currently valid Sepsis-3 definition criteria for septic shock. This investigation examined the effect of obesity on 90-day mortality in patients with septic shock selected from a prospectively enrolled cohort of septic patients. A total of 352 patients who met the Sepsis-3 criteria for septic shock were enrolled in this study. Body-mass index (BMI) was used to divide the cohort into 24% obese (BMI ≥ 30 kg/m
) and 76% non-obese (BMI < 30 kg/m
) patients. Kaplan-Meier survival analysis revealed a significantly lower 90-day mortality (31% vs. 43%;
= 0.0436) in obese patients compared to non-obese patients. Additional analyses of baseline characteristics, disease severity, and microbiological findings outlined further statistically significant differences among the groups. Multivariate Cox regression analysis estimated a significant protective effect of obesity on 90-day mortality after adjustment for confounders. An understanding of the underlying physiologic mechanisms may improve therapeutic strategies and patient prognosis.