High Visceral Adipose Tissue to Subcutaneous Adipose Tissue Ratio as a Predictor of Mortality in Acute Respiratory Distress Syndrome

Background

We aimed to further determine the relationship between the areas of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and the ratio of VAT to SAT (VAT/SAT) with the outcomes of acute respiratory distress syndrome (ARDS) patients.

Methods

A retrospective study was performed on patients with ARDS in 7 intensive care units (ICU) of West China Hospital, Sichuan University.

Results

A total of 169 patients were included in the analysis. Abdominal computed tomography scans of each patient within 24 hours of being admitted to the ICU were assessed by at least 2 investigators. Higher VAT/SAT was related with higher hospital mortality (22% vs. 44%, P?=?0.003; adjusted odds ratio aOR] 0.699, 95% CI 0.530-0.922 (P?=?0.011]). On the contrary, higher SAT and VAT were related to lower hospital mortality in ARDS (aOR 1.077, 95% CI 1.037-1.119 P < 0.001]; aOR 1.017, 95% CI 1.004-1.030 P?=?0.011], respectively). Patients with higher SAT and VAT had shorter length of ICU stay (ICU LOS) (26.26 vs. 15.83 days, P?=?0.031; 25.16 vs. 14.19 days, P?=?0.007, respectively), while VAT/SAT was not related with ICU LOS. Moreover, we did not find any significant relationship either between VAT/SAT and mechanical ventilation-free days or between SAT and mechanical ventilation-free days.

Conclusions

This study suggests that VAT/SAT can contribute to adverse outcomes of patients with ARDS. However, higher SAT and VAT were related to better prognosis of ARDS patients.