Samiksha Gupta, n/a
Resident
University of Oklahoma Heath Sciences Center, United States
Disclosure information not submitted.
Syed Talal Hussain, MD
Pulmonology /Critical care fellow
University of Oklahoma Heath Sciences Center, United States
Disclosure information not submitted.
Huzaifa Jaliawala, MD
Pulmonology /Critical care fellow
University of Oklahoma Heath Sciences Center, United States
Disclosure information not submitted.
Brent Brown, MD
Professor, Pulmonology/ Critical care
University of Oklahoma Health & Sciences Center, United States
Disclosure information not submitted.
Wu Huimin, MD
Assistant Professor, Pulmonology /Critical care
University of Oklahoma Heath Sciences Center, United States
Disclosure information not submitted.
Roberto J. Bernardo, MD
Assistant Professor, Pulmonology /Critical care
University of Oklahoma Heath Sciences Center, United States
Disclosure information not submitted.
Title: Obesity Paradox in Mechanically Ventilated Patients with Refractory Hypoxemia
Introduction: ARDS is characterized by acute elevation of inflammatory markers with profound lung inflammation and damage. It has been hypothesized that obese patients could have a protective phenotype in ARDS, known as the obesity paradox.
Aims: To study the association between obesity and survival in patients with hypoxemic respiratory failure and refractory hypoxia.
To explore the association between obesity and socioeconomic factors.
Methods: Data from the Oklahoma University Right Ventricular Project (OURVP) collected between January 2015 and December 2018 was used. Patients with hypoxemic respiratory failure requiring mechanical ventilation were included in the analysis. We performed Kaplan-Meier survival curves and log-rank test to study the association between obesity and 90-day survival. Cox proportional hazards model, was used for multivariable analysis, adjusting for age, sex, PaO2/FiO2, need for vasopressors, and SOFA score. Further, socioeconomic factors (metropolitan residency, estimated income, race/ethnicity, and health insurance) were compared in obese and non-obese patients. SAS version 9.4 (SAS®, North Carolina) was used for analysis.
Results: 126 patients were included in the analysis, 65 categorized as obese (BMI > 30 kg/m2) and 61 as non-obese. There were no major differences in baseline characteristics between groups. Obese patients had better survival than non-obese patients (HR 0.458 [95% CI, 0.261 – 0.805], p=0.0066). On the multivariable obesity remain an independent factor associated with improved survival (HR 0.539 [ CI 95% 0.309 – 0.959], p=0.0356).
No major association between obesity and socioeconomic factors was seen.