慢性重症患者的肥胖悖论和90天死亡率:使用大型临床数据库的队列研究
1Chongqing Medical University, Chongqing, 400016, People's Republic of China.
European journal of medical research
|July 29, 2024
概括
肥胖悖论有利于慢性严重疾病 (CCI) 患者,较高的体重指数 (BMI) 与较低的死亡率有关,特别是在老年人中. 这表明,增加的BMI可能会在这个脆弱人群中起到保护作用.
科学领域:
- 关键护理医学 关键护理医学
- 流行病学 流行病学
- 老年病的医生 老年病的医生
背景情况:
- 肥胖悖论描述了一个现象,肥胖与特定患者队列的较低死亡率有关.
- 慢性重症患者 (CCI) 是一个独特的人群,肥胖对长期结果的影响需要进一步调查.
研究的目的:
- 调查慢性重病患者的身体质量指数 (BMI) 和长期死亡率之间的关联.
- 为了确定肥胖悖论是否在CCI患者群体中明显.
主要方法:
- 来自MIMIC-IV数据库的1996年CCI患者的回顾性分析.
- 根据身体质量指数 (BMI) 将患者分为六组.
- 逐步多变量考克斯回归和受限立方线模型被用于分析BMI和90天死亡率,控制混因素.
主要成果:
- 与正常体重患者相比,超重和肥胖的CCI患者的90天死亡率明显降低 (HRs 0.60-0.72,p<0.001).
- 使用受限制的立方脊柱模型观察到BMI和90天死亡率之间的负相关性.
- 亚组分析表明,年龄改变了BMI和死亡率之间的关系.
结论:
- 这项研究证实了慢性重症患者的肥胖悖论,高BMI与降低死亡率有关.
- 高BMI的这种保护作用在老年人 (65-85岁) 和非常老年人 (≥85岁) CCI患者中尤为明显.
- 虽然较高的BMI似乎对老年CCI患者有益,但建议45岁以下的个人谨慎使用.
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