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目的:在重症监护室(ICU)患者样本中,为异常身体质量指数(BMI)的发生率提供概况;确定是否有任一医学专科与异常的BMI有关;分析BMI与ICU相关转归的关联。方法:选择2012年11月至2014年6月,在Sir Charles Gairdner医院的三级ICU(23张床位)住院的735例成年患者(年龄中位数为58岁),进行回顾性观察。首要结果测量指标是患者的BMI,低体质量(<18.5 kg/m~2)、正常体质量(18.5~24.99 kg/m~2)、超重(25~29.99 kg/m~2)、肥胖(30~39.99 kg/m~2)或重度肥胖(≥40 kg/m~2);其他测量指标包括性别、急性生理学与慢性健康状况评分系统Ⅱ评分、住院科室、机械通气(MV)时间、住院时间(LOS)和病死率。结果:与普通人群比较,研究队列中肥胖患者的比例更高,绝大部分患者超重(33.9%)或肥胖(36.5%),BMI的中位数为27.9(IQR为7.9)。不同专科患者的BMI无统计学差异(P=0.103)。未发现异常BMI对患者病死率有负面影响(ICU,P=0.373;医院,P=0.330);正常BMI患者比其他类型BMI患者的MV时间更短,BMI对患者ICU LOS的影响取决于MV时间。与正常体质量的患者比较,机械通气时间为5天或更长的超重患者,LOS更短;重度肥胖无机械通气的患者,LOS更长。结论:尽管肥胖-疾病关系日益复杂化,而现有数据只反映了单中心ICU住院患者的不同类别的BMI;但在研究队列中,考虑护理的成本影响仍然可能是重要的,尤其是对MV和LOS的影响。
OBJECTIVE: To provide an overview of the incidence of abnormal body mass index (BMI) in intensive care unit (ICU) patient samples; to determine if any medical specialty is associated with an abnormal BMI; and to analyze the association of BMI with ICU-related outcomes. METHODS: A total of 735 adult patients (median age 58 years) hospitalized at the tertiary ICU (23 beds) at Sir Charles Gairdner Hospital from November 2012 to June 2014 were retrospectively reviewed. The primary outcome measure was the patient’s BMI, body mass (<18.5 kg / m 2), normal body weight (18.5-24.99 kg / m 2), overweight (25-29.99 kg / m 2) 30 ~ 39.99 kg / m ~ 2) or severe obesity (≥40 kg / m ~ 2). Other measures included gender, Acute Physiology and Chronic Health Score II, hospitalization, mechanical ventilation (MV) Time (LOS) and mortality. Results: The proportion of obese patients in the study cohort was higher than in the general cohort. The overwhelming majority of patients were overweight (33.9%) or obese (36.5%), with a median BMI of 27.9 (IQR 7.9). BMI in different specialist patients was not statistically different (P = 0.103). No abnormal BMI was found to have a negative impact on patient mortality (ICU, P = .373; hospital, P = 0.330); MV in patients with normal BMI was shorter than in patients with other types of BMI and the effect of BMI on ICU LOS was dependent on MV time . Compared with patients with normal body mass, LOS was shorter in overweight patients with mechanical ventilation for 5 days or longer; patients with severe obesity without mechanical ventilation had longer LOS. CONCLUSIONS: Despite the increasing complexity of the obesity-disease relationship, and available data reflecting only different categories of BMI in single-ICU hospitalized patients, it may still be important to consider the cost implications of care in the study cohort, especially for MV And LOS effects.