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The effect of obesity on clinical outcomes in presumed sepsis: a retrospective cohort study

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Abstract

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/m2. 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.

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Acknowledgments

A research grant from the Infectious Disease Society of America (IDSA) Medical Scholars Program supported this study.

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Authors and Affiliations

  1. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, CWN-L 1, Rm L111, 75 Francis Street, Boston, MA, 02115, USA

    Timothy Glen Gaulton

  2. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA

    Knashawn Hodge Morales, Jimish Mehta & Ebbing Lautenbach

  3. Department of Biostatistics and Epidemiology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA

    Knashawn Hodge Morales & Ebbing Lautenbach

  4. Division of Infectious Diseases of the Department of Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA

    Ebbing Lautenbach

  5. Division of General Internal Medicine of the Department of Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA

    Mark Gordon Weiner

  6. Department of Emergency Medicine, Center for Resuscitation Science, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA

    David Foster Gaieski

  7. Department of Pharmacy, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Jimish Mehta

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  1. Timothy Glen Gaulton
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Correspondence to Timothy Glen Gaulton.

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Gaulton, T.G., Weiner, M.G., Morales, K.H. et al. The effect of obesity on clinical outcomes in presumed sepsis: a retrospective cohort study. Intern Emerg Med 9, 213–221 (2014). https://doi.org/10.1007/s11739-013-1002-2

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  • DOI: https://doi.org/10.1007/s11739-013-1002-2

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