Critical Care: Sepsis II |

The Impact of Intrathoracic Adipose Tissue on the Mortality of Patients With Septic Shock FREE TO VIEW

Wongun Kwack; Yun-Seong Kang; Yun-Jeong Jeong; Jin Young Oh; Young Soon Yoon
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Dongguk University Ilsan Hospital, Goyang, Korea (the Republic of)

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):365A. doi:10.1016/j.chest.2016.08.378
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Visceral adiposity is associated with increased proinflammatory cytokine and end organ damage. Some reported abdominal adiposity might increase mortality in patients with septic shock. Nonetheless, little is known about the impact of intrathoracic fat. Therefore, we conducted this study to determine the association between intrathoracic adiposity and mortality of septic shock.

METHODS: We performed a retrospective review of patients with septic shock admitted to ICU from December 2012 to December 2014. Among 1417 patients, 99 patients had chest computer tomography (CT) scan during ICU stay. Intrathoracic fat (ITF), epicardial adipose tissue (EAT) and pericardial adipose tissue (PAT) were measured by chest CT scan. Total adipose tissue (TAT), subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT) were measured by abdomen CT.

RESULTS: Mean BMI was 21.1 ± 4.2. Thoracic fat such ITF, EAT, and PAT was positively correlated with abdominal fat such as TAT, VAT, and SAT. However, adiposity of thorax and abdomen were not significantly associated with in-hospital mortality. ITF was 157.7 ± 105.4 among nonsurvivors but 136.0 ± 88.0 among survivors (p=0.37). VAT was 102.5 ± 77.8 among nonsurvivors but 78.1 ± 47.1 among survivors (p=0.065). In univariate analysis, mortality was associated with male, the maximum amount of inotropic, Simplified Acute Physiology Score II, Sequential Organ Failure Assessment score, bacteremia, azotemia, increased lactate level, chronic lung disease, and the ratio of VAT/SAT and VAT/TAT. After adjustment for covariables, age (odds ratio (OR): 1.130 95% confidential interval (CI): 1.018-1.255) and increased lactate level (OR: 1.049 95% CI: 1.003-1.097) showed significant association with in-hospital mortality, but not visceral fat.

CONCLUSIONS: Intrathoracic fat was positively correlated with abdominal fat. However, intrathoracic adiposity was not associated with increased risk of in-hospital mortality in patients with septic shock.

CLINICAL IMPLICATIONS: In patients with septic shock, we identified whether visceral obesity measured from chest CT scan with/without abdomen CT could be the poor prognostic factor of septic shock. Further, larger study will be needed.

DISCLOSURE: The following authors have nothing to disclose: Wongun Kwack, Yun-Seong Kang, Yun-Jeong Jeong, Jin Young Oh, Young Soon Yoon

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