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Abstract Background To investigate the global, regional, and national burden of the diseases attributable to excess body weight (EBW) from 1990 to 2019, stratified by age, sex, underlying cause, and sociodemographic index (SDI). Methods Using the Comparative Risk Assessment approach of the Global Burden of Disease (GBD) study 2019, the burden of diseases attributable to EBW was reported for the period from 1990 to 2019. For adults, EBW was defined as a body mass index (BMI) exceeding 25 kg/m2, while for children aged 1 to 19 years, EBW was determined according to the standards set by the International Obesity Taskforce. The burden was reported in terms of numbers, proportions, and age-standardised rates per 100,000, accompanied by corresponding 95% uncertainty intervals (UIs). Results In 2019, there were an estimated 5.0 million deaths (95% UI: 3.2–7.1) and 160.3 million DALYs (106.0–218.9) attributable to EBW worldwide. The age-standardised DALY rate attributable to EBW increased by 18.0% (2.2–42.3) from 1990 to 2019, with notable regional variations. Southeast Asia and South Asia exhibited the highest age-standardised DALY rates. Conversely, the age-standardised death rate due to EBW showed no significant change, with an increase of 4.9% (-7.3 to 24.6) over the same period. Significant regional variations were again observed, particularly in Southeast Asia and South Asia, which recorded the highest age-standardised death rates. Moreover, a non-linear association was observed between the SDI and the regional age-standardised DALY rate of diseases attributable to EBW. Conclusions The global burden of EBW has increased over the past three decades. This trend aligns with socio-demographic indices and is influenced by the physical activity levels and dietary habits of these populations.

Abstract Background Cardiac surgery is a major contributor to acute kidney injury (AKI); approximately 22% of patients who undergo cardiac surgery develop AKI, and among them, 2% will require renal replacement therapy (RRT). AKI is also associated with heightened risks of mortality and morbidity, longer intensive care stays, and increased treatment costs. Due to the challenges of treating AKI, prevention through the use of care bundles is suggested as an effective approach. This review aimed to assess the impact of care bundles on kidney outcomes, mortality, and hospital stay for cardiac patients in critical care. Methods PubMed, Scopus, Web of Science, and EMBASE were searched up to November 2024. Inclusion criteria were studies on individuals with cardiac diseases receiving critical care, that used AKI care bundle as the intervention, and reported outcomes related to AKI, mortality, and other kidney-related events. We used the Cochrane Collaboration’s risk of bias tool 2 and the Newcastle-Ottawa scale for quality assessment. Pooled odds ratios (ORs) or risk ratios (RRs) with 95% confidence intervals (CIs) were calculated. Results Seven studies on total 5045 subjects, including five observational and two randomized controlled trials (RCTs) were included. The implementation of care bundles significantly reduced the incidence of all-stage AKI (OR: 0.78; 95%CI: 0.61–0.99) and moderate-severe AKI (OR: 0.56; 95%CI: 0.43–0.72). Also, the implementation of care bundle increased the incidence of persistent renal dysfunction after 30 days by 2.39 times. However, there were no significant changes in RRT, major adverse kidney events, or mortality between the groups. The mean quality assessment score for observational studies was 7.2 out of ten, while there were noted concerns in the risk of bias assessment of the RCTs. Conclusions The application of care bundles in patients, including those undergoing cardiac surgeries as well as non-cardiac critical illness, appears to be effective in reducing AKI, particularly in moderate and severe stages. However, given the inclusion of non-cardiac patients in some studies, the observed effect may not be solely attributable to cardiac surgery cases. Future large-scale RCTs focusing specifically on cardiac surgery patients are recommended to clarify the impact of care bundles within this subgroup. Registration ID in PROSPERO CRD42024498972.