Table 1.
Clinical Measurements for Selected BMI-based Categories
| Total | Underweight | Normal -Overweight | Obese | p | |
|---|---|---|---|---|---|
| Total Patients | 1,032 | 105 | 631 | 296 | |
| Demographics | |||||
| Age (years), mean±SD | 63.4 ± 17.0 | 65.1 ± 18.1 | 64.8 ± 17.5 | 59.6 ± 14.9 | <0.001 |
| Male sex, n(%) | 510 (49.4) | 57 (54.3) | 333 (52.8) | 120 (40.5) | 0.001 |
| Body Mass Index (kg/m2), mean±SD | 27.2 ± 8.8 | 16.6 ± 1.6 | 24.0 ± 3.0 | 37.9 ± 8.7 | <0.001 |
| MEDS Score, mean±SD | 10.6 ± 4.7 | 11.6 ± 4.8 | 11.0 ± 4.6 | 9.4 ± 4.5 | <0.001 |
| Time to diagnosis (hr), mean±SD | 1.7 ± 1.5 | 1.3 ± 1.3 | 1.6 ± 1.5 | 1.8 ± 1.6 | 0.015 |
| Special Populations, n(%) | |||||
| Elderly | 488 (47.3) | 55 (52.4) | 324 (51.3) | 109 (36.8) | <0.001 |
| History of End-Stage Renal Disease | 101 (9.8) | 9 (8.6) | 61 (9.7) | 31 (10.5) | 0.84 |
| History of Heart Failure | 245 (23.7) | 20 (19.0) | 137 (21.7) | 88 (29.7) | 0.014 |
| “Overload” | 208 (20.2) | 9 (8.6) | 112 (17.7) | 87 (29.4) | <0.001 |
| Septic Shock | 653 (63.3) | 71 (67.6) | 413 (65.5) | 169 (57.1) | 0.030 |
| Hospital Metrics | |||||
| Emergency Department LOS (hr) mean±SD | 9.4 ± 4.7 | 9.1 ± 4.2 | 9.4 ± 4.7 | 9.6 ± 4.8 | 0.64 |
| ICU admission, n(%) | 606 (58.7) | 60 (57.1) | 380 (60.2) | 166 (56.1) | 0.46 |
| ICU LOS (days), mean±SD | 2.6 ± 4.3 | 2.5 ± 4.5 | 2.6 ± 4.2 | 2.7 ± 4.6 | 0.89 |
| Hospital LOS (days), mean±SD | 9.9 ± 9.4 | 8.9 ± 6.9 | 9.9 ± 9.5 | 10.4 ± 9.7 | 0.35 |
| Mortality, n(%) | 176 (17.1) | 21 (20.0) | 113 (17.9) | 42 (14.2) | 0.26 |
| Severe sepsis (% of severe group) | 43 (11.3) | 2 (5.9) | 33 (15.1) | 8 (6.3) | 0.03 |
| Shock (% of shock group) | 133 (20.4) | 19 (26.8) | 80 (19.4) | 34 (20.1) | 0.36 |
| Sepsis Parameters | |||||
| ≥ SIRS, n(%) | 881 (85.4) | 91 (86.7) | 539 (85.4) | 250 (84.5) | 0.84 |
| ≥ 2 qSOFA, n(%) | 345 (33.4) | 45 (42.9) | 207 (32.8) | 93 (31.4) | 0.09 |
| Volume IVF (L) at 3 hours, median (IQR) | 2.0 (1.0–2.0) | 2.0 (1.4–3.0) | 2.0 (1.0–3.0) | 2.0 (1.0–3.0) | 0.22 |
| Volume IVF (mL) at 3 hours, mean±SD | 2089 ± 1284 | 2111 ± 1170 | 2148 ± 1284 | 1818 ± 1299 | 0.001 |
| 30by3 by Actual Body Weight, n(%) | 509 (49.3) | 84 (80.0) | 356 (56.4) | 69 (23.3) | <0.001 |
| 30by3 by Ideal Body Weight, n(%) | 550 (53.3) | 55 (52.4) | 359 (56.9) | 136 (46.0) | 0.008 |
| IVF (mL/kg) at 3 hours, median (IQR) | 28.1 (13.3–38.9) | 40.1 (30.0–54.8) | 30.0 (17.0–42.0) | 16.5 (6.9–27.9) | <0.001 |
| IVF (mL/kg) at 3 hours for 30by3 vs. 30after3, median | 41.7 vs 15.2 | 49.7 vs 20.0 | 42.0 vs 17.0 | 35.1 vs 11.9 | N/A |
| Mean arterial pressure (mmHg), median (IQR) | 79.5 (66.7–95) | 75.0 (61.7–89.7) | 79.3 (67.1–95.0) | 82.0 (67.3–99.0) | 0.17 |
| Lactate, mmol/L, mean±SD | 3.5 ± 2.7 | 3.7 ± 2.4 | 3.6 ± 2.8 | 3.1 ± 2.2 | 0.015 |
| Time to antibiotics (hr), mean±SD | 1.3 ± 3.3 | 1.5 ± 6.2 | 1.2 ± 2.8 | 1.3 ± 2.7 | 0.59 |
| Intubation, n(%) | 158 (15.3) | 10 (9.5) | 99 (15.7) | 49 (16.6) | 0.21 |
| Vasopressor, n(%) | 215 (20.8) | 24 (22.9) | 129 (20.4) | 62 (20.9) | 0.85 |
| Positive blood cultures, n(%) | 325 (31.5) | 29 (27.6) | 188 (29.8) | 108 (36.5) | 0.082 |
| Sepsis Source, n(%) | |||||
| Pneumonia | 313 (30.3) | 39 (37.1) | 208 (33.0) | 66 (22.3) | 0.001 |
| Genitourinary | 248 (24.0) | 24 (22.9) | 138 (21.9) | 86 (29.1) | 0.055 |
| Abdominal | 151 (14.6) | 14 (13.3) | 95 (15.1) | 42 (14.2) | 0.87 |
| Skin/soft tissue | 143 (13.9) | 10 (9.5) | 79 (12.5) | 54 (18.2) | 0.025 |
| Indwelling IV catheter | 53 (5.1) | 5 (4.8) | 32 (5.1) | 16 (5.4) | 0.96 |
| Other/unknown | 124 (12.0) | 13 (12.4) | 79 (12.5) | 32 (10.8) | 0.75 |
Table 1describes the study cohort, separated by body mass index (BMI). Underweight represents BMI <18.5 kg/m2. Normal represents 18.5 ≤ BMI <30.0 kg/m2. Obese represents BMI ≥30 kg/m2. Legend: MEDS = mortality in emergency department sepsis, LOS = length of stay, ICU = intensive care unit, SIRS = systemic inflammatory response syndrome (defined in Supplementary 2), qSOFA = quick sequential organ failure assessment (defined in Supplementary 2). IVF = intravenous fluids, IQR = interquartile range. Statistical significance defined as p < 0.05.