Prevalence and impact of overweight and obesity in critically ill surgical patients: Analysis of THAI-SICU study

© 2016, Medical Association of Thailand. All rights reserved. Objective: To investigate the prevalence of overweight and obesity, and their impacts in patients admitted to a surgical intensive care unit (SICU) in Thailand. Material and Method: We conducted an analysis using the THAI-SICU database. A...

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Main Authors: Petch Wacharasint, Pusit Fuengfoo, Ram Rangsin, Sunthiti Morakul, Kaweesak Chittawattanarat, Onuma Chaiwat
Format: Journal
Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/56078
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-560782018-09-05T03:08:39Z Prevalence and impact of overweight and obesity in critically ill surgical patients: Analysis of THAI-SICU study Petch Wacharasint Pusit Fuengfoo Ram Rangsin Sunthiti Morakul Kaweesak Chittawattanarat Onuma Chaiwat Medicine © 2016, Medical Association of Thailand. All rights reserved. Objective: To investigate the prevalence of overweight and obesity, and their impacts in patients admitted to a surgical intensive care unit (SICU) in Thailand. Material and Method: We conducted an analysis using the THAI-SICU database. All 4,579 patients who had weight and height measured were classified into four groups using body mass index (BMI) based on the World Health Organization criteria, which were 1) underweight (BMI <18.5 kg/m2), 2) normal BMI (BMI 18.5-24.9 kg/m2), 3) overweight (BMI 25-29.9 kg/m2), and 4) obese (BMI >30 kg/m2) groups. Primary outcome was prevalence of overweight and obesity. Secondary outcomes were 28-day survival, and SICU outcomes between four patient groups. Results: There were 768 (16.8%) of underweight, 2,624 (57.3%) of normal BMI, 858 (18.7%) of overweight, and 329 (7.2%) of obese patients. Compared to other three patient groups, obese had the highest 28-day survival (log-rank, p<0.001), lowest incidence of systemic inflammatory response syndrome (SIRS) (underweight 41.1%, normal BMI 35.6%, overweight 34.5%, and obese 29.5%; p = 0.001), and lowest incidence of new infection (underweight 27.3%, normal BMI 23.3%, overweight 24.5%, and obese 20.4%; p = 0.047). After adjustment for related confounding factors, we found that every one unit increasing of BMI associated with lower risk of hospital mortality [odds ratio, OR, 0.97(95% confidence interval, CI, 0.94- 0.99); p = 0.04], higher risk of acute respiratory distress syndrome (ARDS) [OR 1.06 (95% CI 1.03-1.08); p<0.001], and higher risk of intra-abdominal hypertension (IAH) [OR 1.06 (95% CI 1.03-1.09); p<0.001]. Conclusion: The prevalence of overweight and obesity in Thai critically ill surgical patients were 18.7% and 7.2%, respectively. Compared to patients with lower BMI, patients with higher BMI had significantly lower mortality but greater risk of ARDS and IAH. 2018-09-05T03:08:39Z 2018-09-05T03:08:39Z 2016-09-01 Journal 01252208 2-s2.0-85012214813 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85012214813&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/56078
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
Petch Wacharasint
Pusit Fuengfoo
Ram Rangsin
Sunthiti Morakul
Kaweesak Chittawattanarat
Onuma Chaiwat
Prevalence and impact of overweight and obesity in critically ill surgical patients: Analysis of THAI-SICU study
description © 2016, Medical Association of Thailand. All rights reserved. Objective: To investigate the prevalence of overweight and obesity, and their impacts in patients admitted to a surgical intensive care unit (SICU) in Thailand. Material and Method: We conducted an analysis using the THAI-SICU database. All 4,579 patients who had weight and height measured were classified into four groups using body mass index (BMI) based on the World Health Organization criteria, which were 1) underweight (BMI <18.5 kg/m2), 2) normal BMI (BMI 18.5-24.9 kg/m2), 3) overweight (BMI 25-29.9 kg/m2), and 4) obese (BMI >30 kg/m2) groups. Primary outcome was prevalence of overweight and obesity. Secondary outcomes were 28-day survival, and SICU outcomes between four patient groups. Results: There were 768 (16.8%) of underweight, 2,624 (57.3%) of normal BMI, 858 (18.7%) of overweight, and 329 (7.2%) of obese patients. Compared to other three patient groups, obese had the highest 28-day survival (log-rank, p<0.001), lowest incidence of systemic inflammatory response syndrome (SIRS) (underweight 41.1%, normal BMI 35.6%, overweight 34.5%, and obese 29.5%; p = 0.001), and lowest incidence of new infection (underweight 27.3%, normal BMI 23.3%, overweight 24.5%, and obese 20.4%; p = 0.047). After adjustment for related confounding factors, we found that every one unit increasing of BMI associated with lower risk of hospital mortality [odds ratio, OR, 0.97(95% confidence interval, CI, 0.94- 0.99); p = 0.04], higher risk of acute respiratory distress syndrome (ARDS) [OR 1.06 (95% CI 1.03-1.08); p<0.001], and higher risk of intra-abdominal hypertension (IAH) [OR 1.06 (95% CI 1.03-1.09); p<0.001]. Conclusion: The prevalence of overweight and obesity in Thai critically ill surgical patients were 18.7% and 7.2%, respectively. Compared to patients with lower BMI, patients with higher BMI had significantly lower mortality but greater risk of ARDS and IAH.
format Journal
author Petch Wacharasint
Pusit Fuengfoo
Ram Rangsin
Sunthiti Morakul
Kaweesak Chittawattanarat
Onuma Chaiwat
author_facet Petch Wacharasint
Pusit Fuengfoo
Ram Rangsin
Sunthiti Morakul
Kaweesak Chittawattanarat
Onuma Chaiwat
author_sort Petch Wacharasint
title Prevalence and impact of overweight and obesity in critically ill surgical patients: Analysis of THAI-SICU study
title_short Prevalence and impact of overweight and obesity in critically ill surgical patients: Analysis of THAI-SICU study
title_full Prevalence and impact of overweight and obesity in critically ill surgical patients: Analysis of THAI-SICU study
title_fullStr Prevalence and impact of overweight and obesity in critically ill surgical patients: Analysis of THAI-SICU study
title_full_unstemmed Prevalence and impact of overweight and obesity in critically ill surgical patients: Analysis of THAI-SICU study
title_sort prevalence and impact of overweight and obesity in critically ill surgical patients: analysis of thai-sicu study
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85012214813&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/56078
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