Body Mass Index Is Associated with the Severity and All-Cause Mortality of Acute Kidney Injury in Critically Ill Patients: An Analysis of a Large Critical Care Database
Autor: | Diwen Li, Benji Wang, Bihuan Cheng, Laifang Sun, Yuqiang Gong, Binyu Ying |
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Rok vydání: | 2021 |
Předmět: |
Male
Critical Care Databases Factual Article Subject Critical Illness 030204 cardiovascular system & hematology Overweight computer.software_genre Logistic regression Severity of Illness Index General Biochemistry Genetics and Molecular Biology Body Mass Index 03 medical and health sciences 0302 clinical medicine Confidence Intervals medicine Humans 030212 general & internal medicine Stage (cooking) Aged Aged 80 and over General Immunology and Microbiology Database Critically ill Proportional hazards model business.industry Acute kidney injury General Medicine Acute Kidney Injury medicine.disease Obesity Medicine Female medicine.symptom business computer Body mass index Research Article |
Zdroj: | BioMed Research International BioMed Research International, Vol 2021 (2021) |
ISSN: | 2314-6141 2314-6133 |
DOI: | 10.1155/2021/6616120 |
Popis: | Background. Acute kidney injury (AKI) is a common clinical syndrome carrying high morbidity and mortality. Body mass index (BMI) is a common health indicator, and a high BMI value-obesity has been shown to be associated with the outcomes of several diseases. However, the relationship between different BMI categories and mortality in all critically ill patients with AKI is unclear and needs further investigation. Therefore, we evaluated the ability of BMI to predict the severity and all-cause mortality of AKI in critically ill patients. Methods. We extracted clinical data from the MIMIC-III v1.4 database. All adult patients with AKI were initially screened. The baseline data extracted within 24 hours after ICU admission were presented according to WHO BMI categories. Logistic regression models and the Cox proportional hazards models were, respectively, constructed to assess the relationship between BMI and the severity and all-cause mortality of AKI. The generalized additive model (GAM) was used to identify nonlinear relationships as BMI was a continuous variable. The subgroup analyses were performed to further analyze the stability of the association between BMI category and 365-day all-cause mortality of AKI. Result. A total of 15,174 patients were extracted and were divided into four groups according to BMI. Obese patients were more likely to be young and male. In the fully adjusted logistic regression model, we found that overweight and obesity were significant predictors of AKI stage III (OR, 95 CI: 1.17, 1.05–1.30; 1.32, 1.18–1.47). In the fully adjusted Cox proportional hazards model, overweight and obesity were associated with significantly lower 30-day, 90-day, and 365-day all-cause mortality. The corresponding adjusted HRs (95 CIs) for overweight patients were 0.87 (0.77, 0.99), 0.84 (0.76, 0.93), and 0.80 (0.74, 0.88), and for obese patients, they were 0.87 (0.77, 0.98), 0.79 (0.71, 0.88), and 0.73 (0.66, 0.80), respectively. The subgroup analyses further presented a stable relationship between BMI category and 365-day all-cause mortality. Conclusions. BMI was independently associated with the severity and all-cause mortality of AKI in critical illness. Overweight and obesity were associated with increased risk of AKI stage III; however, they were predictive of a relatively lower mortality risk in these patients. |
Databáze: | OpenAIRE |
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