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. 2023 Jul 3;11(1):27.
doi: 10.1186/s40560-023-00677-0.

Association of body mass index with mortality of sepsis or septic shock: an updated meta-analysis

Le Bai #  1 , Jingyi Huang #  2 , Dan Wang #  1 , Dongwei Zhu  1 , Qi Zhao  1 , Tingyuan Li  1 , Xianmei Zhou  3   4 , Yong Xu  5
Affiliations

Association of body mass index with mortality of sepsis or septic shock: an updated meta-analysis

Le Bai et al. J Intensive Care. .

Abstract

Background: The effects of body mass index (BMI) on mortality of sepsis remain unknown, since previous meta-analyses have reported conflicting results. Several observational studies published recently have provided new evidence. Thus, we performed this updated meta-analysis.

Methods: PubMed, Embase, Web of Science, and Cochran Library were searched for articles published before February 10, 2023. Observational studies that assessed the association of BMIs with mortality of sepsis patients aged > 18 years were selected. We excluded studies of which data were unavailable for quantitative synthesis. Odds ratios (OR) with 95% confidence interval (CI) were the effect measure, which were combined using fixed-effect or random-effect models. The Newcastle-Ottawa Scale was applied for quality assessment. Subgroups analyses were conducted according to potential confounders.

Results: Fifteen studies (105,159 patients) were included in the overall analysis, which indicated that overweight and obese BMIs were associated with lower mortality (OR: 0.79, 95% CI 0.70-0.88 and OR: 0.74, 95% CI 0.67-0.82, respectively). The association was not significant in patients aged ≤ 50 years (OR: 0.89, 95% CI 0.68-1.14 and OR: 0.77, 95% CI 0.50-1.18, respectively). In addition, the relationship between morbidly obesity and mortality was not significant (OR: 0.91, 95% CI 0.62-1.32).

Conclusions: Overweight and obese BMIs (25.0-39.9 kg/m2) are associated with reduced mortality of patients with sepsis or septic shock, although such survival advantage was not found in all crowds. Trial registration The protocol of this study was registered in PROSPERO (registration number CRD42023399559).

Keywords: Body mass index; Meta-analysis; Mortality; Obesity; Sepsis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The flow chart of study selection
Fig. 2
Fig. 2
Individual and pooled results of the association of underweight, overweight, obese, and morbidly obese BMIs with mortality in patients with sepsis
Fig. 3
Fig. 3
The funnel plot of the publication bias assessment for obese BMI (30.0–39.9 kg/m2) groups. BMI body mass index
See this image and copyright information in PMC

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