SHM Converge Scientific Abstract ePoster Gallery-Clinical Outcomes of Community-Onset Sepsis in Patients With Obesity

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This multicenter study examined whether obesity affects outcomes in adults hospitalized with community-onset sepsis. Using data from 67 Michigan hospitals (11/2020–05/2023), researchers included 35,499 patients with sepsis or related infections and objective evidence of infection plus acute organ dysfunction by hospital day 2. They compared patients with obesity to those with normal BMI and adjusted for age, sex, prior healthcare exposure, lab values, comorbidities, predicted mortality, hospital effects, and mechanical ventilation.<br /><br />Key findings:<br />- Patients with obesity were younger than those with normal BMI and had a higher rate of soft tissue infections.<br />- Their predicted mortality was lower at baseline.<br />- Initial sepsis resuscitation bundle completion was similar between groups (about 37%).<br />- Some care processes differed: patients with obesity were less likely to receive lung-protective ventilation and less likely to have goals-of-care conversations.<br /><br />Outcomes were better in the obesity group:<br />- In-hospital mortality or hospice discharge: 13.6% vs 23.7% in normal BMI<br />- 30-day mortality: 13.9% vs 24.2%<br />- 90-day mortality: 18.2% vs 31.4%<br /><br />After adjustment, obesity remained associated with lower mortality:<br />- In-hospital mortality/hospice: adjusted OR 0.82 (95% CI 0.76–0.89)<br />- 30-day mortality: adjusted OR 0.81 (0.74–0.87)<br />- 90-day mortality: adjusted OR 0.76 (0.71–0.82)<br /><br />The authors conclude that among patients with community-onset sepsis, obesity was linked to lower mortality even after accounting for illness severity, consistent with an “obesity paradox.” They note important limitations, including possible collider stratification bias and the limitations of BMI as a measure of adiposity.

Asset Subtitle

David Paje

Meta Tag

Author List David Paje, Elizabeth McLaughlin, Emily A. Walzl, Hallie Prescott, Jennifer K. Horowitz, Scott A. Flanders, Steven J. Bernstein

Category Research

Concept Obesity

Concept Sepsis

Concept Mortality

Concept Clinical Outcome

Concept BMI Category

Distinguished Non-Finalist

Presenter Organization University of Michigan

Presenting Author David Paje

Track Quality Improvement

Keywords

obesity

community-onset sepsis

mortality

multicenter study

BMI

Michigan hospitals

adjusted odds ratio

obesity paradox

acute organ dysfunction

hospitalized patients

Obesity

Sepsis

Mortality

Clinical Outcome

BMI Category