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Critical Care

Open Access

Obesity is not associated with poor outcomes in older patients with sepsis

  • MI Restrepo1,
  • P Faverio2,
  • LF Reyes3 and
  • A Anzueto1
Critical Care201418(Suppl 1):P47

Published: 17 March 2014


Studies suggest that obesity may influence mortality in patients who develop sepsis. However, the mechanisms linked to improved outcomes are unclear. Our aim was to assess the impact of obesity on mortality at 30 and 180 days and cytokine expression.


We used a platform of a negative randomized control trial in subjects (n = 51) with a diagnosis of severe sepsis with ≥1 organ failure. The cohort of severe septic subjects was stratified by obesity status based on the body mass index (BMI >30). Primary outcomes: 30-day and 180-day mortality; secondary outcome: difference in median (IQR) of five inflammatory cytokines including tumor necrosis factor alpha (TNFα), TNFα-receptor 2, interleukin (IL)-6, IL-1-receptor-antagonist (IL- 1ra) and IL-10. The measurement of median baseline cytokine levels was done in serum by Luminex technology. Statistical significance was defined as P < 0.05.


Fifty-one subjects with severe sepsis were included in the study; 37% of the patients were obese (BMI >30). Paradoxically, obese severe septic patients had lower 30-day mortality (n = 1 (5%) vs. n = 9 (28%), P = 0.069) and 180-day mortality (n = 1 (5%) vs. n = 13 (41%), P = 0.008), when compared with nonobese. The expression of TNFα, TNFα-receptor 2, IL-6, IL-1ra and IL-10 was not statistically significant different among obese versus nonobese severe septic patients.


Obesity is associated with lower mortality rates at 30 and 180 days in patients diagnosed with severe sepsis. This survival benefit was not associated with lower cytokine production among obese patients. Further studies are needed to assess the mechanisms associated with the survival benefit related to obesity in patients with severe sepsis.

Authors’ Affiliations

University of Texas Health Science Center, San Antonio, USA
University of Milan-Bicocca, Monza, Italy
Universidad de La Sabana, Bogota, Colombia


© Restrepo et al.; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.