Sex-based outcomes of obesity in critically ill patients: a retrospective cohort study

BACKGROUND: Obesity is increasingly prevalent among critically ill patients, generally more common among females than males. Whether the patient's sex influences the outcome in these patients is unclear. OBJECTIVE: Evaluate the outcomes of critically ill-patients with obesity admitted to the in...

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Main Authors: Mohammed Alqahtani, Farhan Alenezi, Musharaf Sadat, Hani Tamim, Felwa Bin Humaid, Nahla Awadh Albaalharith, Yaseen Arabi
Format: Article
Language:English
Published: King Faisal Specialist Hospital and Research Centre 2025-03-01
Series:Annals of Saudi Medicine
Online Access:http://www.annsaudimed.net/doi/10.5144/0256-4947.2025.79
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author Mohammed Alqahtani
Farhan Alenezi
Musharaf Sadat
Hani Tamim
Felwa Bin Humaid
Nahla Awadh Albaalharith
Yaseen Arabi
author_facet Mohammed Alqahtani
Farhan Alenezi
Musharaf Sadat
Hani Tamim
Felwa Bin Humaid
Nahla Awadh Albaalharith
Yaseen Arabi
author_sort Mohammed Alqahtani
collection DOAJ
description BACKGROUND: Obesity is increasingly prevalent among critically ill patients, generally more common among females than males. Whether the patient's sex influences the outcome in these patients is unclear. OBJECTIVE: Evaluate the outcomes of critically ill-patients with obesity admitted to the intensive care unit (ICU). DESIGN: A retrospective cohort study SETTING: ICU of King Abdulaziz Medical City, Riyadh, Saudi Arabia PATIENTS AND METHODS: All obese patients aged more than 18 years admitted to ICU between 2002 to 2017 were included. MAIN OUTCOME MEASURES: The primary outcome was hospital mortality. Secondary outcomes included ICU mortality, ICU and hospital lengths of stay, mechanical ventilation duration, renal replacement therapy, vasopressor use, and tracheostomy. A multivariable analysis was conducted to evaluate the association of sex differences with hospital mortality. SAMPLE SIZE: 7277 patients RESULTS: Of the included patients with obesity, 3965 were females, and 3312 were males. The females were older, more likely to be admitted for medical reasons and less likely for trauma than males. The crude hospital mortality rate was significantly higher in females than males (1056 [26.7%] vs. 744 [22.5%], P<.0001). Multivariable analysis demonstrated no association between sex and hospital mortality (OR: 1.05, 95% CI: 0.94, 1.19, P=.52). However, age (OR: 1.04; 95% CI: 1.01–1.02; P<.0001), chronic liver disease (OR: 5.04; 95% CI: 4.19–6.06; P<.0001), and chronic renal disease (OR: 2.19; 95% CI: 1.86–2.57;P<.0001) were found to be associated with higher mortality while admission due to trauma showed lower mortality (OR: 0.69; 95% CI: 0.53–0.90; P=.007). CONCLUSION: Obese females admitted to ICU have a higher hospital crude mortality rate than obese males. This difference does not appear to be related to sex, but rather to older age, higher comorbid conditions, and more frequent admissions related to non-trauma reasons among females. LIMITATIONS: A single-center retrospective study
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spelling doaj-art-938c24cf8bd04ddcbcd5f1bdb65f399f2025-08-20T02:25:45ZengKing Faisal Specialist Hospital and Research CentreAnnals of Saudi Medicine0256-49470975-44662025-03-01452798510.5144/0256-4947.2025.79Sex-based outcomes of obesity in critically ill patients: a retrospective cohort studyMohammed Alqahtani0Farhan Alenezi1Musharaf Sadat2Hani Tamim3Felwa Bin Humaid4Nahla Awadh Albaalharith5Yaseen Arabi6From the Department of Intensive Care Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaFrom the Department of Intensive Care Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaFrom the Department of Intensive Care Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaFrom the Department of Clinical Research Institute, American University of Beirut, Beirut, LebanonFrom the Intensive Care Unit, King Abdulaziz Medical City, King Abdullah International Medical Research Center, RIyadh, Saudi ArabiaFrom the Nursing Services/Clinical Trial Unit, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaFrom the Department of Intensive Care Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaBACKGROUND: Obesity is increasingly prevalent among critically ill patients, generally more common among females than males. Whether the patient's sex influences the outcome in these patients is unclear. OBJECTIVE: Evaluate the outcomes of critically ill-patients with obesity admitted to the intensive care unit (ICU). DESIGN: A retrospective cohort study SETTING: ICU of King Abdulaziz Medical City, Riyadh, Saudi Arabia PATIENTS AND METHODS: All obese patients aged more than 18 years admitted to ICU between 2002 to 2017 were included. MAIN OUTCOME MEASURES: The primary outcome was hospital mortality. Secondary outcomes included ICU mortality, ICU and hospital lengths of stay, mechanical ventilation duration, renal replacement therapy, vasopressor use, and tracheostomy. A multivariable analysis was conducted to evaluate the association of sex differences with hospital mortality. SAMPLE SIZE: 7277 patients RESULTS: Of the included patients with obesity, 3965 were females, and 3312 were males. The females were older, more likely to be admitted for medical reasons and less likely for trauma than males. The crude hospital mortality rate was significantly higher in females than males (1056 [26.7%] vs. 744 [22.5%], P<.0001). Multivariable analysis demonstrated no association between sex and hospital mortality (OR: 1.05, 95% CI: 0.94, 1.19, P=.52). However, age (OR: 1.04; 95% CI: 1.01–1.02; P<.0001), chronic liver disease (OR: 5.04; 95% CI: 4.19–6.06; P<.0001), and chronic renal disease (OR: 2.19; 95% CI: 1.86–2.57;P<.0001) were found to be associated with higher mortality while admission due to trauma showed lower mortality (OR: 0.69; 95% CI: 0.53–0.90; P=.007). CONCLUSION: Obese females admitted to ICU have a higher hospital crude mortality rate than obese males. This difference does not appear to be related to sex, but rather to older age, higher comorbid conditions, and more frequent admissions related to non-trauma reasons among females. LIMITATIONS: A single-center retrospective studyhttp://www.annsaudimed.net/doi/10.5144/0256-4947.2025.79
spellingShingle Mohammed Alqahtani
Farhan Alenezi
Musharaf Sadat
Hani Tamim
Felwa Bin Humaid
Nahla Awadh Albaalharith
Yaseen Arabi
Sex-based outcomes of obesity in critically ill patients: a retrospective cohort study
Annals of Saudi Medicine
title Sex-based outcomes of obesity in critically ill patients: a retrospective cohort study
title_full Sex-based outcomes of obesity in critically ill patients: a retrospective cohort study
title_fullStr Sex-based outcomes of obesity in critically ill patients: a retrospective cohort study
title_full_unstemmed Sex-based outcomes of obesity in critically ill patients: a retrospective cohort study
title_short Sex-based outcomes of obesity in critically ill patients: a retrospective cohort study
title_sort sex based outcomes of obesity in critically ill patients a retrospective cohort study
url http://www.annsaudimed.net/doi/10.5144/0256-4947.2025.79
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