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. 2021 Jan 15;11(1):1615.
doi: 10.1038/s41598-020-80284-3.

Association between low body mass index and increased 28-day mortality of severe sepsis in Japanese cohorts

Takehiko Oami  1 , Satoshi Karasawa  1 , Tadanaga Shimada  1 , Taka-Aki Nakada  2 , Toshikazu Abe  3   4 , Hiroshi Ogura  5 , Atsushi Shiraishi  6 , Shigeki Kushimoto  7 , Daizoh Saitoh  8 , Seitaro Fujishima  9 , Toshihiko Mayumi  10 , Yasukazu Shiino  11 , Takehiko Tarui  12 , Toru Hifumi  13 , Yasuhiro Otomo  14 , Kohji Okamoto  15 , Yutaka Umemura  5 , Joji Kotani  16 , Yuichiro Sakamoto  17 , Junichi Sasaki  18 , Shin-Ichiro Shiraishi  19 , Kiyotsugu Takuma  20 , Ryosuke Tsuruta  21 , Akiyoshi Hagiwara  22 , Kazuma Yamakawa  23 , Tomohiko Masuno  24 , Naoshi Takeyama  25 , Norio Yamashita  26 , Hiroto Ikeda  27 , Masashi Ueyama  28 , Satoshi Fujimi  23 , Satoshi Gando  29   30 ; JAAM FORECAST Group
Collaborators, Affiliations

Association between low body mass index and increased 28-day mortality of severe sepsis in Japanese cohorts

Takehiko Oami et al. Sci Rep. .

Abstract

Current research regarding the association between body mass index (BMI) and altered clinical outcomes of sepsis in Asian populations is insufficient. We investigated the association between BMI and clinical outcomes using two Japanese cohorts of severe sepsis (derivation cohort, Chiba University Hospital, n = 614; validation cohort, multicenter cohort, n = 1561). Participants were categorized into the underweight (BMI < 18.5) and non-underweight (BMI ≥ 18.5) groups. The primary outcome was 28-day mortality. Univariate analysis of the derivation cohort indicated increased 28-day mortality trend in the underweight group compared to the non-underweight group (underweight 24.4% [20/82 cases] vs. non-underweight 16.0% [85/532 cases]; p = 0.060). In the primary analysis, multivariate analysis adjusted for baseline imbalance revealed that patients in the underweight group had a significantly increased 28-day mortality compared to those in the non-underweight group (p = 0.031, adjusted odds ratio [OR] 1.91, 95% confidence interval [CI] 1.06-3.46). In a repeated analysis using a multicenter validation cohort (underweight n = 343, non-underweight n = 1218), patients in the underweight group had a significantly increased 28-day mortality compared to those in the non-underweight group (p = 0.045, OR 1.40, 95% CI 1.00-1.97). In conclusion, patients with a BMI < 18.5 had a significantly increased 28-day mortality compared to those with a BMI ≥ 18.5 in Japanese cohorts with severe sepsis.

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Conflict of interest statement

This work was supported by the Japanese Association for Acute Medicine (JAAM). The JAAM had no role in the study design, analysis of the data, or preparation of the manuscript. Tadanaga Shimada is currently receiving a grant (FDN 20K09301) from “Japan Society for the Promotion of Science”. The remaining authors have disclosed that they do not have any conflicts of interest.

Figures

Figure 1
Figure 1
Comparison of blood IL-6 levels between the underweight (BMI < 18.5) and non-underweight (BMI ≥ 18.5) group at days 1, 2, and 3. There was a non-significant trend of increased blood IL-6 levels in the underweight group compared to the non-underweight group in a generalized estimating equation using log-converted serum IL-6 concentration at days 1, 2, and 3 (p = 0.088, adjusted OR 1.24, 95% CI 0.96–1.60). IL interleukin, BMI body mass index.
See this image and copyright information in PMC

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