Impact of obesity in patients infected with 2009 influenza A(H1N1)

Emili Díaz, Alejandro Rodríguez, Ignacio Martin-Loeches, Leonardo Lorente, María Del Mar Martín, Juan Carlos Pozo, Juan Carlos Montejo, Angel Estella, Ángel Arenzana, Jordi Rello, Pedro Cobo, Javier Martins, Cecilia Carbayo, Emilio Robles-Musso, Antonio Cárdenas, Javier Fierro, Ocaña Fernández, Rafael Sierra, Ma Jesús Huertos, R. GuerreroEnrique Márquez, Manuel Rodríguez-Carvajal, Antonio Jareño, José Pomares, José Luis Ballesteros, Yolanda Fernández, Francisco Lobato, José F. Prieto, José Albofedo-Sánchez, Pilar Martínez, Miguel Angel Díaz Castellanos, Guillermo Sevilla, José Garnacho-Montero, Rafael Hinojosa, Esteban Fernández, Ana Loza, Cristóbal León, Dolores Ocaña, Manuel Luis Avellanas, Arantxa Lander, S. Garrido Ramírez De Arellano, M. I.Marquina Lacueva, Pilar Luque, Ignacio González, Jose Ma Montón, Jose Ma Díaz, Pilar López-Reina, Sergio Sáez, Lisardo Iglesias, Carmen Pascual González, Quiroga, Águeda García-Rodríguez, Lorenzo Socias, Pedro Ibánez, Marcío Borges-Sa, A. Socias, A. Del Castillo, Ricard Jordà Marcos, José M. Bonell, Ignacio Amestarán, Sergio Ruiz-Santana, Juan José Díaz, Sisón, David Hernández, Ana Trujillo, Luis Regalado, Mar Martín, Sergio Martínez, J. J. Cáceres, Borja Suberviola, P. Ugarte, Fernando García-López, Angel Álvaro Alonso, Antonio Pasilla, Ma Luisa Gómez Grande, Antonio Albaya, Alfonso Canabal, Luis Marina, Juan B.López Messa, Ma Jesús López Pueyo, Zulema Ferreras, Santiago Macias, José Ángel Berezo, Jesús Blanco Varela, Ojeda A. Andaluz, Antonio Álvarez Terrero, Fabiola Tena Ezpeleta, Rosa Ma Catalán, Miquel Ferrer, Antoni Torres, Sandra Barbadillo, Lluís Cabré, Assumpta Rovira, Francisco Álvarez-Lerma, Antonia Vázquez, Joan Nolla, Francisco Fernández, Joaquim Ramón Cervelló, Rafael Mañéz, J. Ballús

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77 Citations (Scopus)

Abstract

Objective: A large proportion of patients infected with 2009 influenza A(H1N1)(A[H1N1]) are obese. Obesity has been proposed as a risk factor influencing outcome in these patients. However, its role remains unclear. We evaluate the outcome of patients who are obese and infected with A(H1N1) in the ICU, determining whether obesity is a risk factor for mortality. Methods: This was a prospective, observational, and multicenter study performed in 144 ICUs in Spain. Data were obtained from the Grupo de Trabajo en Enfermedades Infecciosas de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (GTEI/SEMICYUC) registry. Adult patients with A (H1N1) that was confirmed by real-time polymerase chain reaction were included in the analysis. Patients who were obese (BMI>30) were compared with patients who were nonobese. Cox regression analysis was used to determine adjusted mortality. Differences of P<.05 were considered significant. Results: In January 2010, the GTEI/SEMICYUC registry had complete records for 416 patients. One hundred and fifty patients (36.1%) were obese, of whom 67 (44.7%) were morbidly obese (BMI>40). Mechanical ventilation (MV) was more frequently applied in patients who were obese (64% vs 52.4%, P<.01) Patients with obesity remained on MV longer than patients who were nonobese (6.5 ± 10.3 days vs 9.3 ± 9.7 days, P =.02), had longer ICU length of stay(10.8 ± 12.1 days vs 13.7 ± 11.7 days, P=.03), and had longer hospitalization (18.2 ± 14.6 days vs 22.2 ± 16.5 days, P=.02). Mortality adjusted by severity and potential confounders identified that obesity was not significantly associated with ICU mortality (hazard ratio, 1.1;95% CI, 0.69-1.75; P=.68). Conclusions: In our cohort, patients who were obese and infected with A (H1N1) did not have increased mortality. However, there was an association between obesity and higher ICU resource consumption. © 2011 American College of Chest Physicians.
Original languageEnglish
Pages (from-to)382-386
JournalChest
Volume139
Issue number2
DOIs
Publication statusPublished - 1 Feb 2011

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