Key result
In adults with sepsis, obesity class I was associated with lower short-term mortality compared to normal weight (16% vs 24%; adjusted OR 0.61; 95% CI 0.57-0.66).
Why the study?
Prior observational studies linking obesity to sepsis survival were small, used administrative data, or failed to adequately adjust for confounders, leaving the relationship between BMI and sepsis mortality uncertain.
Does higher body mass index reduce short-term mortality in adult inpatients with sepsis?
Comparison
Six BMI categories vs normal weight
Design
Multicenter retrospective cohort study
Authors
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Supports obesity paradox in sepsis; hypothesis-generating and should not change practice pending confirmation.
Cohort (n=55,038)
Yes
Does higher body mass index reduce short-term mortality in adult inpatients with sepsis?
Odds Ratio: 0.61 (95% CI 0.57–0.66)
Absolute Event Rate: 16% vs 24%
In adults with clinically defined sepsis, higher body mass index is associated with lower short-term mortality compared to normal weight, demonstrating an obesity paradox.
Pepper et al. (2019) conducted a cohort in Sepsis (n=55,038). Higher body mass index (obese class I) vs. Normal weight (BMI 18.5-24.9 kg/m2) was evaluated on Short-term mortality (in-hospital death or discharge to hospice) (OR 0.61, 95% CI 0.57-0.66). In adults with sepsis, obesity class I was associated with lower short-term mortality compared to normal weight (16% vs 24%; adjusted OR 0.61; 95% CI 0.57-0.66).
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