Acute and Critical Care

Dae Jong Choi

2 Articles

Body Mass Index and Outcomes in Patients with Severe Sepsis or Septic Shock: Minjung Kathy Chae, Dae Jong Choi, Tae Gun Shin, Kyeongman Jeon, Gee Young Suh, Min Seob Sim, Keun Jeong Song, Yeon Kwon Jeong, Ik Joon Jo; Korean J Crit Care Med. 2013;28(4):266-271.; DOI: https://doi.org/10.4266/kjccm.2013.28.4.266

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BACKGROUND
The aim of this study was to investigate the association between body mass index (BMI) and survival in patients with severe sepsis or septic shock.
METHODS
We analyzed the sepsis registry of patients presenting to the emergency department (ED) of a tertiary urban hospital and meeting the criteria for severe sepsis or septic shock from August 2008 to March 2012. We categorized patients into the underweight group (BMI < 18.5 kg/m2), the normal weight group (18.5 < or = BMI < 25 kg/m2) and the obese group (BMI > or = 25 kg/m2). Then, we analyzed the registry to evaluate the relation between obesity and in-hospital mortality.
RESULTS
A total of 770 adult patients with severe sepsis and septic shock were analyzed. In-hospital mortality rate of the underweight group (n = 86), the normal weight group (n = 489) and the obese group (n = 195) was 22.1%, 15.3% and 16.4%, respectively. In a multivariate regression analysis, the underweight group had a significant association with in-hospital mortality compared with the normal weight group (odds ratio [OR], 1.12; 95% confidence interval [CI], 0.68-1.87; p = 0.028). The obese group showed no significant difference in mortality (OR, 2.04; 95% CI, 1.08-3.86; p = 0.65).
CONCLUSIONS
The underweight patients showed significantly higher mortality than the normal weight patients with severe sepsis and septic shock.

Citations

Citations to this article as recorded by

Association of body mass index with mortality of sepsis or septic shock: an updated meta-analysis
Le Bai, Jingyi Huang, Dan Wang, Dongwei Zhu, Qi Zhao, Tingyuan Li, Xianmei Zhou, Yong Xu
Journal of Intensive Care.2023;[Epub] CrossRef
Necrotizing soft tissue infection: analysis of the factors related to mortality in 30 cases of a single institution for 5 years
Sung Jin Park, Dong Heon Kim, Chang In Choi, Sung Pil Yun, Jae Hun Kim, Hyung Il Seo, Hong Jae Jo, Tae Yong Jun
Annals of Surgical Treatment and Research.2016; 91(1): 45. CrossRef

Effect of Hydrogel Pad and Conventional Method on the Induction Time of Therapeutic Hypothermia in Patients with Out-of-Hospital Cardiac Arrest: Ga Young Chung, Tae Rim Lee, Dae Jong Choi, Sung Su Lee, Mun Ju Kang, Won Chul Cha, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Yeon Kwon Jeong; Korean J Crit Care Med. 2012;27(4):218-223.; DOI: https://doi.org/10.4266/kjccm.2012.27.4.218

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Abstract PDF: BACKGROUND
Therapeutic hypothermia has been recommended as a standard treatment of cardiac arrest patients after return of spontaneous circulation. There are various methods to drop patient's core body temperature below 33.5degrees C. We compared the cooling rate of the conventional cooling method using cold saline bladder irrigation with the commercial hydrogel pad in out-of-hospital cardiac arrest (OHCA) patients.
METHODS
We collected data retrospectively from the Samsung Medical Center hypothermia database. The conventional method group was cooled with IV infusion of 2,000 ml of 4degrees C cold saline and cold saline bladder irrigation. Patients in the hydrogel pad group had their body temperature lowered with the Artic Sun(R) after receiving 2,000 ml of 4degrees C cold saline intravenously. The induction time was defined as time from cold saline infusion to the esophageal core temperature below 33.5degrees C. The esophageal temperature probe insertion to the target temperature time (ET to target BT time) was defined as the time from the esophageal probe insertion to the core temperature below 33.5degrees C. We compared these times and cooling rates between the two groups.
RESULTS
Eighty one patients were enrolled. Fifty seven patients were included in the hydrogel pad group and 24 patients were in the conventional group. There were no statistical differences of baseline characteristics between the two groups. The induction time of the conventional group (138 min., IQR 98-295) was shorter than that of the hydrogel pad group (190 min., IQR 140-250). The ET to target BT time of the conventional group (106 min., IQR 68-249) was shorter than that of the hydrogel pad group (163 min., IQR 108-222). The cooling rate of the conventional group (0.93degrees C/hr., IQR 0.58-2.08) was lower than that of the hydrogel pad group (1.05degrees C/hr., IQR 0.74-1.96). However, there were no statistical differences in the induction time, the ET to target BT time and the cooling rate between the two groups.
CONCLUSIONS
There was no significant statistical difference of the cooling rate of the hydrogel pad and conventional method on the induction time of therapeutic hypothermia in Patients with OHCA. The conventional cooling method can be used as an effective and efficient way to lower OHCA patient's core body temperature during the induction phase of therapeutic hypothermia.

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