Abstract
Background
Obesity has recently become more prevalent, and thus the coexistence of liver cirrhosis
with obesity has become very pervasive. The purpose of this study is to investigate
the correlation between abnormal body mass index (BMI) (overweight and obese) and
clinical outcomes in critically ill cirrhotic patients.
Methods
This is a single-center, prospective observational study of cirrhotic patients admitted
to the intensive care unit for either medical or surgical indications in the period
from February 2018 to December 2020. Patients were categorized based on their body
mass index and the reason for admission to the intensive care unit (ICU).
Results
The current study enrolled 517 patients; 39.3% were overweight, and 19.5% were obese
(85% were class 1 and 2). Surgical subgroup analysis revealed that the hospital stay was shorter in the obese
than average weight patients (p-value= 0.039), and ICU stay was shorter in overweight
patients than patients with average weight (p-value= 0.022). The incidence of acute
kidney injury was shorter in the obese group than in overweight and average-weight
patients (p-value= 0.045). The medical subgroup analysis revealed that the need for
noninvasive ventilation was lower in the obese and overweight groups than in the normal
group (p-value= 0.040).
Conclusions
Despite having similar Child-Pugh (CP) and Sequential Organ Failure Assessment Score
(SOFA) scores on admission, obese patients had better outcomes than non-obese patients,
demonstrating the obesity paradox. Further research is required on BMI as a predictive
score in a patient with critical cirrhosis as an indicator of obesity.
Keywords
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Article info
Publication history
Published online: June 16, 2022
Accepted:
June 13,
2022
Received:
August 12,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
