Obesity is a major public health problem worldwide and is associated with increased morbidity and mortality. However, studies have shown that obesity has sepsis-related mortality benefits. We aimed to determine whether there is an improved sepsis-related survival rate in patients with obesity in South Korea. We included data from 77,810 adults with sepsis between 1 January 2013 and 31 December 2020, extracted from the National Health Insurance Service database in South Korea. The patients underwent standard health examinations within a year before sepsis, and body mass index (BMI) and waist circumference (WC) were used to reflect obesity. Lower 30-day and 1-year mortality rates were observed in the overweight and obesity groups after adjusting for confounders, including WC. However, there was no difference in mortality between the patients with severe obesity and those with normal BMI. Underweight was associated with higher 30-day and 1-year mortality. Higher 30-day and 1-year mortality was found in the high and very high WC groups. In conclusion, patients with abdominal obesity and overweight and obesity and with sepsis showed reduced mortality, whereas underweight patients with sepsis showed increased mortality in South Korea.
Keywords: body mass index; mortality; obesity; sepsis; waist circumference.