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Association of body mass index and bloodstream infections in patients on extracorporeal membrane oxygenation: a single-centre, retrospective, cohort study

Authors
 E H Lee  ;  J A Lee  ;  J Y Ahn  ;  S J Jeong  ;  N S Ku  ;  J Y Choi  ;  J-S Yeom  ;  Y G Song  ;  S H Park  ;  J H Kim 
Citation
 JOURNAL OF HOSPITAL INFECTION, Vol.140 : 117-123, 2023-10 
Journal Title
JOURNAL OF HOSPITAL INFECTION
ISSN
 0195-6701 
Issue Date
2023-10
MeSH
Adult ; Body Mass Index ; Candidemia* ; Cohort Studies ; Extracorporeal Membrane Oxygenation* / adverse effects ; Female ; Humans ; Male ; Middle Aged ; Obesity / complications ; Obesity / epidemiology ; Retrospective Studies
Abstract
Background: Obesity is associated with poor clinical outcomes in critically ill patients. However, under some clinical conditions, obesity has protective effects. Bloodstream infections (BSI) are among the most common nosocomial infections associated with extracorporeal membrane oxygenation (ECMO). BSI during ECMO is associated with higher mortality rates and poorer clinical outcomes. Aim: To analyse whether body mass index (BMI) is associated with BSI during ECMO or with in-hospital mortality. Methods: All adult patients who had received ECMO support for >48 h were included in the analysis. The analysis of total duration of ECMO support, in-hospital mortality and BSI was stratified by BMI category. The Cox proportional hazards model was used to compare the risk of BSI among BMI categories. Findings: In total, 473 patients were enrolled in the study. The average age was 56.5 years and 65.3% were men. The total duration of ECMO was approximately 11.8 days, with a mortality rate of 47.1%. The incidence rates of BSI and candidaemia were 20.5% and 5.5%, respectively. The underweight group required ECMO for respiratory support, whereas the overweight and obese groups required ECMO for cardiogenic support (P<0.0001). No significant difference in BSI rate was found (P=0.784). However, after adjusting for clinical factors, patients in Group 4 (BMI 25.0–<30.0 kg/m2) exhibited lower mortality compared with patients in Group 2 (normal BMI) (P=0.004). Conclusion: BMI was not associated with risk of BSI, but patients with higher BMI showed lower in-hospital mortality associated with ECMO support. © 2023 The Healthcare Infection Society
Full Text
https://www.sciencedirect.com/science/article/pii/S0195670123002578
DOI
10.1016/j.jhin.2023.08.005
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, Jung Ho(김정호) ORCID logo https://orcid.org/0000-0002-5033-3482
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Ahn, Jin Young(안진영) ORCID logo https://orcid.org/0000-0002-3740-2826
Yeom, Joon Sup(염준섭) ORCID logo https://orcid.org/0000-0001-8940-7170
Lee, Eun Hye(이은혜) ORCID logo https://orcid.org/0000-0003-2570-3442
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/198001
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