Evaluating the obesity paradox in patients with sepsis and cancer
Authors' conclusion
The obesity paradox is evident in both short-term outcome (28-day mortality) and long-term outcomes (6-month and 1-year mortality) among patients with sepsis and cancer, particularly in those presenting with lower disease severity. These findings highlight the need for personalized treatment approaches in this complex patient population.
Study context
- Population
- Intensive care unit (ICU) patients with sepsis and cancer, Medical Information Mart for Intensive Care IV database
- Participants
- 3,914 patients
- Exposure
- Body mass index (BMI) categories
- Underweightn = 173
- Normal weightn = 1,283reference
- Overweightn = 1,498
- Obesityn = 960
- Outcome
- 28-day mortality
- Follow-up
- 28 days
Methodological detailsMIMIC-IV database, multivariable logistic regression, restricted cubic splines, unsupervised clustering
- MIMIC-IV database
- Multivariable logistic regression
- Restricted cubic splines
- Unsupervised clustering
Main finding
As reported in the abstract
- Obesity was associated with lower mortality
Observational data: associations, not effects.
Secondary outcomes
Mortality by phenotype cluster
- Four distinct phenotypes; protective effect of obesity more evident in patients with lower Sequential Organ Failure Assessment (SOFA) scores (Cluster1, Cluster2 and Cluster3)
Original publication
Evaluating the obesity paradox in patients with sepsis and cancer. Int J Obes (Lond). Published 12 May 2025. doi:10.
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