Table 1. Characteristics of included studiesthat examined the effect of obesityonmorbidity of ARDS/ALI.
| Author | Year | Studydesign | Sample size | BMI classification(kg/m2) | ARDS/ALI diagnostic standard | Outcomes |
|---|---|---|---|---|---|---|
| Anna M. Bramley | 2012 | retrospective Study | 154 | normal (BMI<30), obese (BMI 30–39.9), morbid obese (BMI ≥40) | NA | Morbidity: OR 1.928, 95% CI 0.718–5.181 |
| Binod Dhakal | 2013 | retrospective study | 320 | normal (BMI<25), obese (BMI ≥25) | NA | Morbidity: OR 0.3, 95% CI 0.027–3.349 |
| Huang Lei | 2013 | retrospective study | 184 | NA | American European Consensus Conference definition* | Morbidity: OR 5.023, 95% CI 2.486–10.150 |
| I Bonmarin | 2015 | retrospective study | 3074 | normal (BMI<30), obese (BMI ≥30) | NA | Morbidity: OR 1.8, 95% CI 1.1–3.0 |
| Jessica A. Palakshappa | 2016 | prospective study | 164 | underweight (BMI<18.5), normal (BMI 18.5–25), overweight (BMI 25–30), obese (BMI ≥30) | ARDS: both PaO2/FiO2 ratio<200 and bilateral infiltrates on chest radiographs within a 24-hour period | Morbidity: OR 2.388, 95% CI 1.075–5.305 |
| John C. Weinlein | 2015 | retrospective study | 507 | normal (BMI<25), overweight (BMI 25–29.9)obese (BMI 30–39.9), morbid obese (BMI ≥40) | ARDS: PaO2/FiO2 ratio<200 for >12 hours, bilateral infiltrates on chest radiographs, and no evidence of a cardiogenic cause. | Morbidity: OR 35.38, 95% CI 1.79–699.7; |
| Jonathan Elmer | 2013 | retrospective study | 697 | normal (BMI≤30), obese (BMI >30) | ALI: diffuse, bilateral infiltrates on chestradiograph; at least two consecutive arterialblood gassamples with a PaO2:FiO2ratio < 300 mmHg; no evidence of left atrial hypertension. | Morbidity: OR 1.67, 95% CI 1.25–2.24 |
| Juan C. Duchesne | 2009 | retrospective study | 12759 | normal (BMI≤29), obese (BMI 30–39.9), morbid obese (BMI ≥40) | American European Consensus Conference definition | Morbidity: OR 1.59, 95% CI 0.90–2.82 |
| Lesly A. Dossett | 2008 | prospective study | 1291 | National Heart, Lung, and Blood Institute guidelines# | ARDS: the presence of bilateral patchy infiltrates seen on a chest radiograph; a PaO2/fraction of inspired oxygen ratio of < 200; and the absence of cardiogenic pulmonary edema | Morbidity: OR 0.36, 95% CI 0.13–0.99 |
| Lioudmila V. Karnatovskaia | 2014 | prospective study | 5584 | National Heart, Lung, and Blood Institute guidelines | American European Consensus Conference definition | Morbidity: OR 1.69, 95% CI 0.98–2.8 |
| Mark A Newell | 2007 | retrospective study | 1543 | normal (BMI 18.5–24.9), overweight (BMI 25–29.9), obese (BMI 30–39.9), morbid obese (BMI ≥40) | NA | Morbidity: OR 3.675, 95% CI 1.237–10.916 |
| Michelle Ng Gong | 2010 | prospective study | 1795 | National Heart, Lung, and Blood Institute guidelines | American European Consensus Conference definition | Morbidity: OR 1.78, 95% CI 1.12–2.92; |
| Monisha A. Kumar | 2012 | retrospective study | 69 | normal (BMI<30), obese (BMI ≥30) | ARDS: PaO2/FiO2 ratio <200, bilateral lung infiltrates by radiography and a central venous pressure <18 mmHg. ALI: a PaO2/FiO2 ratio <300. | Morbidity: OR 2.01, 95% CI 0.489–8.27 |
| Natalia Hagau | 2010 | prospective study | 32 | normal (BMI≤30), obese (BMI >30) | American European Consensus Conference definition | Morbidity: OR 13.33, 95% CI 1.434–123.98; |
| Shihua Yao | 2013 | prospective study | 364 | normal (BMI≤28), obese (BMI >28) | American European Consensus Conference definition | Morbidity: OR 3.25, 95% CI 0.392–26.916 |
| Shirin Towfigh | 2009 | prospective study | 2046 | normal (BMI<30), obese (BMI≥30) | American European Consensus Conference definition | Morbidity: OR 1.57, 95% CI 1.01–2.45 |
BMI, body mass index; ALI, acute lung injury; ARDS, acute respiratory distress syndrome.
*American European Consensus Conference definition:the presence of bilateral patchy infiltrates seen on a chest radiograph; hypoxemia (PaO2 /FiO2< 300-ALI, PaO2 /FiO2< 200-ARDS); the absence of cardiogenic pulmonary edema.
#BMI classification by National Heart, Lung, and Blood Institute guidelines: underweight (BMI≤18.5), normal (BMI 18.5–25), overweight (BMI 25–29.9), obese (BMI 30–39.9), morbid obese (BMI ≥40)