韩国内科重症监护病房中可能的肥胖低通气综合征：临床特征与结局
Probable obesity hypoventilation syndrome in a Korean medical intensive care unit: clinical characteristics and outcomes.
文献信息
| PMID | 42754525 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Kyu Jin Lee |
| 作者单位 | Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea. |
| 期刊 | The Korean journal of internal medicine |
| SCI 分区 | Q2 |
| IF | 2.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景/目的： 肥胖低通气综合征（OHS）与发病率及重症监护病房（ICU）使用相关。然而，来自亚洲ICU的数据有限。我们评估了韩国内科ICU（MICU）收治的肥胖患者中可能OHS的比例、特征及结局。
方法： 我们分析了2016年至2023年间首尔大学医院MICU收治的肥胖成人（体重指数[BMI] ≥ 27 kg/m²）。可能OHS定义为肥胖伴慢性高碳酸血症（PaCO₂ ≥ 45 mmHg且碳酸氢盐 ≥ 27 mmol/L）且无其他原因。比较了可能OHS组与肥胖非可能OHS组的临床特征和结局。使用逆概率治疗加权（IPTW）评估死亡率。
结果： 在3,660例MICU入院患者中，531例（14.5%）为肥胖。可能OHS的比例总体为0.4%（16/3,660），肥胖患者中为3.0%（16/531），BMI ≥ 30 kg/m²时为6.5%（12/186）。阻塞性气道疾病在可能OHS组中更为普遍。大多数符合可能OHS标准的患者在MICU住院期间未被识别。尽管入院时疾病严重程度较低，可能OHS患者往往住院时间更长（40天 vs. 24天，p = 0.083）。虽然可能OHS组的未调整死亡率较低，但IPTW调整分析显示院内或90天死亡率无显著差异。
结论： 这项单中心研究发现，3%的肥胖MICU患者患有可能OHS。这些发现表明，潜在的OHS在ICU中可能被忽视，凸显了改进识别和诊断策略的必要性。
英文摘要
BACKGROUND/AIMS: Obesity hypoventilation syndrome (OHS) is associated with morbidity and intensive care unit (ICU) utilization. However, data from Asian ICUs are limited. We evaluated the proportion, characteristics, and outcomes of probable OHS among obese patients admitted to a medical ICU (MICU) in Korea.
METHODS: We analyzed obese adults (body mass index [BMI] ≥ 27 kg/m²) admitted to the MICU at Seoul National University Hospital between 2016 and 2023. Probable OHS was defined as obesity with chronic hypercapnia (PaCO₂ ≥ 45 mmHg and bicarbonate ≥ 27 mmol/L) without alternative causes. Clinical characteristics and outcomes were compared between the probable OHS and obese non-probable OHS groups. Mortality was evaluated using inverse probability of treatment weighting (IPTW).
RESULTS: Among 3,660 MICU admissions, 531 patients (14.5%) were obese. The proportion of probable OHS was 0.4% (16/3,660) overall, 3.0% (16/531) among obese patients, and 6.5% (12/186) at BMI ≥ 30 kg/m². Obstructive airway disease was more prevalent in the probable OHS group. Most patients meeting probable OHS criteria went unrecognized during their stay in the MICU. Patients with probable OHS tended to have longer hospital stays (40 vs. 24 days, p = 0.083), despite lower illness severity at admission. Although unadjusted mortality was lower in the probable OHS group, IPTW-adjusted analyses showed no significant differences in in-hospital or 90-day mortality.
CONCLUSION: This single-center study found that 3% of obese MICU patients had probable OHS. These findings suggest that underlying OHS may be overlooked in the ICU, highlighting the need for improved recognition and diagnostic strategies.