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The following is a summary of “Obesity Is Associated With Increased Mortality in Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation,” published in the December 2024 issue of Critical Care by McCloskey et al.
Researchers conducted a retrospective study to investigate the relationship between all-cause hospital mortality and morbidity in individuals treated with venoarterial extracorporeal membrane oxygenation (ECMO) and to specify if body mass index (BMI) mediated the relationship.
They analyzed venoarterial ECMO runs from the Extracorporeal Life Support Organization (ELSO) registry, covering 2015 to 2021. Patient demographics, ECMO indications, and complications were compared between survivors and decedents. Logistic regression with fractional polynomials was applied to analyze the impact of BMI on mortality and complications in patients with venoarterial ECMO.
The results showed 22,825 venoarterial ECMO runs met the inclusion criteria. The mean BMI for survivors was 28.4 ± 6.5 kg/m2, compared to 29.5 ± 6.9 kg/m2 for decedents. The BMI was significantly linked to mortality (P < 0.001), with death rates rising as BMI increased: 47% of underweight patients, 50% in the normal range, 53% in preobese, 56% in class 1 obese, 58% in class 2 obese, and 65% in class 3 obese. Compared to a BMI of 25, a BMI of 35 had an odds ratio (OR) of 1.15 (1.09–1.18) for death, while a BMI of 45 had an OR of 1.46 (1.25–1.57), BMI was also significantly associated with higher mechanical and renal complications but lower pulmonary complications.
Investigators concluded the patients undergoing venoarterial ECMO, an increasing BMI was linked with a higher risk of all-cause mortality and had an increased incidence of mechanical and renal complications.
Source: journals.lww.com/ccmjournal/abstract/9900/obesity_is_associated_with_increased_mortality_in.431.aspx
