Journal article
Body-mass index and long-term risk of sepsis-related mortality: a population-based cohort study of 0.5 million Chinese adults
- Abstract:
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Background
Sepsis represents a major worldwide healthcare burden. However, how body-mass index (BMI) is related to the long-term risk of sepsis-related mortality in low- and middle-income countries remains uncertain.
Methods
We examined the associations of sepsis-related mortality with both baseline BMI and waist circumference (WC) using data from China Kadoorie Biobank, a prospective cohort recruited during 2004–2008 and followed up to December 2016. After excluding participants with chronic obstructive pulmonary disease, tuberculosis, cancer, heart disease, and stroke, and omitting the first 3 years of follow-up, 440,763 participants remained for analysis.
Results
During a median follow-up of 10.0 years, 1957 sepsis-related deaths (3,134,870 person-years) were included for analysis. Compared with reference BMI of 22.5 to < 25.0 kg/m2, the multivariable-adjusted hazard ratios (HRs) for sepsis-related mortality were 2.42 (95% CIs 2.07–2.84) for BMI of < 18.5, 1.59 (1.36–1.85) for 18.5 to < 20.0, 1.21 (1.06–1.38) for 20.0 to < 22.5, 0.97 (0.83–1.13) for 25.0 to < 27.5, 0.98 (0.80–1.21) for 27.5 to < 30.0, and 1.22 (0.93–1.60) for ≥ 30.0 kg/m2. Further adjustment for WC led to slightly augmentation of the effect size for the lower BMI groups and null association in the obese group. In the association analysis between WC and sepsis-related mortality, compared with the middle quintile group, only the highest quintile group showed an increased risk of sepsis-related mortality after adjusted for BMI (HR = 1.54; 95% CI 1.28–1.84).
Conclusions
Underweight, lower normal weight, and abdominal obesity are associated with increased future risk of sepsis-related mortality over 10 years in the Chinese population. The double burden of underweight and obesity indicates a heavy sepsis burden faced by low- and middle-income countries.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 863.9KB, Terms of use)
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- Publisher copy:
- 10.1186/s13054-020-03229-2
Authors
- Publisher:
- BioMed Central
- Journal:
- Critical Care More from this journal
- Volume:
- 24
- Issue:
- 1
- Article number:
- 534
- Publication date:
- 2020-08-31
- Acceptance date:
- 2020-08-07
- DOI:
- EISSN:
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1466-609X
- ISSN:
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1364-8535
- Pmid:
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32867859
- Language:
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English
- Keywords:
- Pubs id:
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1129789
- Local pid:
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pubs:1129789
- Deposit date:
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2020-10-13
- ARK identifier:
Terms of use
- Copyright holder:
- Weng et al.
- Copyright date:
- 2020
- Rights statement:
- ©2020 The Author(s). Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
- Licence:
- CC Attribution (CC BY)
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