Association Between Body Weight Variation and Survival and Other Adverse Events in Critically Ill Patients With Shock: A Multicenter Cohort Study of the OUTCOMEREA Network - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Critical Care Medicine Année : 2018

Association Between Body Weight Variation and Survival and Other Adverse Events in Critically Ill Patients With Shock: A Multicenter Cohort Study of the OUTCOMEREA Network

C. Dupuis
S. Ruckly
  • Fonction : Auteur
A. Lautrette
M. Garrouste-Orgeas
  • Fonction : Auteur
M. Gainnier
  • Fonction : Auteur
J. M. Forel
  • Fonction : Auteur
G. Marcotte
  • Fonction : Auteur
E. Azoulay
Y. Cohen
  • Fonction : Auteur
C. Schwebel
  • Fonction : Auteur
E. De Montmollin
  • Fonction : Auteur
S. Siami
  • Fonction : Auteur
D. Goldgran-Toledano
  • Fonction : Auteur
J. F. Timsit
  • Fonction : Auteur

Résumé

Objectives: This study in critically ill patients with shock assessed the prognostic value of body weight variations occurring each day from day 3 to day 7 on the 30-day outcome in terms of mortality, occurrence of ventilator-associated pneumonia and of bedsore, and occurrence of length of stay. Design: Retrospective analysis of data. Multivariate subdistribution survival models were used at each day, from day 3 to day 7. The impact of body weight variations on length of stay was estimated through a multivariate negative binomial regression model. Setting: Prospective multicenter cohort study. Patients: Critically ill patients admitted in ICU with shock and requiring mechanical ventilation within 48 hours. Intervention: None. Measurements and Main Results: Two-thousand three-hundred seventy-four patients were included. Their median body weight variations increased from 0.4kg (interquartile range, 0-4.8kg) on day 3 to 3kg (interquartile range, -0.4 to 8.2kg) on day 7. Categories of body weight variations were defined depending on body weight variations interquartiles: weight loss, no weight gain, moderate and severe weight gain. A severe weight gain tended to be associated with death at days 5 and 6 (day 5: subdistribution hazard ratio, 1.27; 95% CI, 0.99-1.63; p = 0.06 and day 6: subdistribution hazard ratio, 1.43; 95% CI, 1.08-1.89; p = 0.01), a weight loss tended to be associated with bedsore, and a severe gain between at days 5 and 6 was associated with ventilator-associated pneumonia. Any body weight variations were associated with an increased length of stay. Conclusions: In survivors at day 3, body weight variations during the first days of ICU stay might be a clinically relevant tool to prevent weight gain but also for prognostication of 30-day mortality, occurrence of ventilator-associated pneumonia, and occurrence of prolonged ICU stay.
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Dates et versions

hal-02003438 , version 1 (01-02-2019)

Identifiants

  • HAL Id : hal-02003438 , version 1

Citer

A. Gros, C. Dupuis, S. Ruckly, A. Lautrette, M. Garrouste-Orgeas, et al.. Association Between Body Weight Variation and Survival and Other Adverse Events in Critically Ill Patients With Shock: A Multicenter Cohort Study of the OUTCOMEREA Network. Critical Care Medicine, 2018, 46 (10), pp.E981--E987. ⟨hal-02003438⟩
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