Role of obesity in reducing the risk of mortality in sepsis: a meta-analysis of observational studies

In this research, We evaluated obesity, obesity and mortality in patients with septicemia, which increases the mortality risk in sepsis and obese patients. We used data sources, such as PubMed, Embase, and the Cochrane Library, without language restrictions. In this project, a prospective population study was used to compare the septicemia, obesity group and healthy control group, and to analyze the disability rate and mortality rate of the septicemia and obesity groups. The risk of deviation was evaluated by the Newcastle Ottawa Quality Assessment scale (New Caussley Review Scale Scale, NOS). In data synthesis, data with odds ratio (OR), Hazard Ratio (HR) and 95% confidence interval (CI) are collected for Meta-analysis, additionally, publication bias was investigated using a funnel plot. The pooled prevalence of mortality in patients with sepsis and obesity (this included 28,216 individuals) was 21.64% (95% CI: 0.22-0.36; I2=100%; P<0.00001). Nine cohort studies investigated survival in hospitalized patients with obesity and sepsis, and the pooled analysis showed no significant difference in overall mortality (HR=0.74; 95% CI: 0.63-0.87; I2=68.0%; P=0.72). However, in the Intensive Care Unit (ICU), the proportion of patients with septicemia and obesity was reduced. (HR=0.72; 95% CI: 0.57-0.90; I2=27%; P=0.005). It was also related to the probability of hospital death (HR=0.76; 95% CI: 0.60-0.96; I2=77%; P=0.02). At follow-up, there was no change in 30-day and 90-day mortality, but there was a reduction in mortality at the 1-year follow-up. From this meta-analysis, it was found that there was a reduction in mortality in patients with sepsis and obesity, which may confirm the obesity paradox. More prospective trials and mechanistic studies are required to validate this hypothesis.