ArticleIntensive care medicine2021
Obesity and risk of catheter-related infections in the ICU. A post hoc analysis of four large randomized controlled trials.
Article in Intensive care medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Obesity and the risk of catheter-related bloodstream infection: a systematic review and meta-analysis.Antimicrobial resistance and infection control · 2022Pooled it
- Practice guideline on the prevention and treatment of central line-associated bloodstream infection: Part 2 - Treatment.Journal of intensive medicine · 2026Article
- Comprehensive management of hemodialysis catheter-related bloodstream infections: a narrative review.Frontiers in cellular and infection microbiology · 2026Review
- Norepinephrine use at extubation in critically ill patients with obesity: a cohort study with multicenter validation.Intensive care medicine · 2025Observational
- The Rate of Procedures Required to Maintain Hemodialysis Vascular Access: A Data Linkage Analysis.Kidney360 · 2025Article
- Genetic correlations and causal associations between BMI, HDL-C, and postoperative infections: a two-sample Mendelian randomization study.Scientific reports · 2025Article
- Prognostic value of the lactate-to-albumin ratio in critically ill chronic heart failure patients with sepsis: insights from a retrospective cohort study.Frontiers in medicine · 2025Article
- The role of cyclic di-GMP in biomaterial-associated infections caused by commensal Escherichia coli.PloS one · 2025Article
- Specific and Non-specific Aspects and Future Challenges of ICU Care Among COVID-19 Patients with Obesity: A Narrative Review.Current obesity reports · 2024Review
- Development and validation of a multivariable model predicting the required catheter dwell time among mechanically ventilated critically ill patients in three randomized trials.Annals of intensive care · 2023Article
- The impact of obesity on the outcome of severe SARS-CoV-2 ARDS in a high volume ECMO centre: ECMO and corticosteroids support the obesity paradox.Journal of critical care · 2022Article
- Determinants and outcomes of bloodstream infections related to obesity.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Article
- Development and validation of a multivariable prediction model of central venous catheter-tip colonization in a cohort of five randomized trials.Critical care (London, England) · 2022Article
- Risk factors for early PICC removal: A retrospective study of adult inpatients at an academic medical center.PloS one · 2022Observational
- Ultrasound-guided catheterization and infectious risk in obese ICU patients.Intensive care medicine · 2021Article
- More is not better: the complicated relationship between obesity, critical illness, and infection.Intensive care medicine · 2021Article
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10 authors at 5 institutions in 5 countries.
Funding
Abstract
purposeObesity increases the risk of nosocomial infection, but data regarding the role of body mass index (BMI) in catheter related infections are scarce. We used the data gathered from four randomized, controlled trials (RCTs) to investigate the association between body mass index (BMI) and intravascular catheter infections in critically ill obese patients.
methodsAdult obese patients who required short-term central venous, arterial or dialysis catheter insertion in the intensive care unit (ICU) were analyzed. The association between BMI and major catheter-related infection (MCRI), catheter-related bloodstream infection (CRBSI) and catheter tip colonization was estimated using univariate and multivariate marginal Cox models. Exploratory analysis using dressing disruptions was added.
resultsA total of 2282 obese patients and 4275 catheters from 32 centers were included in this post-hoc analysis. Overall, 66 (1.5%) MCRI, 43 (1%) CRBSI and 399 (9.3%) catheter colonizations were identified. The hazard ratio (HR) for MCRI, CRBSI and colonization increased with BMI. After adjustment for well-known infection risk factors, the BMI ≥ 40 group had an increased risk for MCRI (HR 1.88, 95% CI 1.13-3.12, p = 0.015), CRBSI (HR 2.19, 95% CI 1.19-4.04, p = 0.012) and colonization (HR 1.44, 95% CI 1.12-1.84, p = 0.0038) compared to the BMI < 40 group. The mean dressing disruption per catheter was increased in the BMI ≥ 40 group (2.03 versus 1.68 in the BMI < 40 group, p = 0.05).
conclusionsUsing the largest dataset ever collected from large multicentric RCTs, we showed that patients with BMI ≥ 40 had an increased risk for intravascular catheter infections. Targeted prevention measures should focus on this population with a particular attention to catheter care and dressing disruption.
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