tetano
Editor, Senior Moderator
Obes Res Clin Pract
. 2021 Apr 5;S1871-403X(21)00052-1.
doi: 10.1016/j.orcp.2021.03.010. Online ahead of print.
Impact of obesity on influenza compared to pneumonia hospitalization outcomes
Chen Wei[SUP] 1 [/SUP], Frank Qian[SUP] 2 [/SUP], Ye Liu[SUP] 3 [/SUP], Luigi Maione[SUP] 4 [/SUP], Huei-Ching Hsu[SUP] 5 [/SUP], Wan-Ting Hsu[SUP] 6 [/SUP], Chien-Chang Lee[SUP] 7 [/SUP]
Affiliations
Abstract
Objectives: Previous literature has suggested that obesity impacts mortality risk differently in bacterial versus viral infections. This study sought to further elucidate this association in pneumonia versus influenza.
Design: Retrospective cohort study.
Setting and participants: Data were collected from the US Nationwide Readmission Database from 2013 to 2014.
Methods: Patients were categorized into three weight groups: normal weight (BMI 18.5-25.0 kg/m[SUP]2[/SUP]), obese (BMI 30-40.0 kg/m[SUP]2[/SUP]), and morbidly obese (BMI ? 40 kg/m[SUP]2[/SUP]). To minimize confounding, we excluded patients with a history of smoking, alcoholism, or chronic wasting conditions, as suggested by the Global BMI Mortality Collaboration. To further isolate obesity from baseline differences across cohorts, we performed a three-way propensity matching analysis. The association between body weight and in-hospital all-cause 30-day mortality was assessed using Cox proportional hazard regression analysis.
Results: 132,965 influenza and 34,177 pneumonia hospitalizations were identified. For patients with influenza, obesity (hazard ratio
: 1.51; 95% CI: 1.01-2.26) and morbid obesity (HR: 1.64; 95% CI: 1.10-2.44) were associated with higher in-hospital 30-day mortality compared to normal weight. For pneumonia, obesity (HR, 0.41; 95% CI, 0.20-0.84) and morbid obesity (HR, 0.49; 95% CI, 0.25-0.96) were associated with reduced 30-day mortality compared to normal weight.
Conclusions and implications: Obesity may increase 30-day mortality risk during influenza hospitalization but provide mortality benefit in pneumonia, a divergent effect not adequately explained by lower admission threshold.
Keywords: Influenza; Morbid obesity; Mortality; Obesity; Pneumonia.
. 2021 Apr 5;S1871-403X(21)00052-1.
doi: 10.1016/j.orcp.2021.03.010. Online ahead of print.
Impact of obesity on influenza compared to pneumonia hospitalization outcomes
Chen Wei[SUP] 1 [/SUP], Frank Qian[SUP] 2 [/SUP], Ye Liu[SUP] 3 [/SUP], Luigi Maione[SUP] 4 [/SUP], Huei-Ching Hsu[SUP] 5 [/SUP], Wan-Ting Hsu[SUP] 6 [/SUP], Chien-Chang Lee[SUP] 7 [/SUP]
Affiliations
- PMID: 33832874
- DOI: 10.1016/j.orcp.2021.03.010
Abstract
Objectives: Previous literature has suggested that obesity impacts mortality risk differently in bacterial versus viral infections. This study sought to further elucidate this association in pneumonia versus influenza.
Design: Retrospective cohort study.
Setting and participants: Data were collected from the US Nationwide Readmission Database from 2013 to 2014.
Methods: Patients were categorized into three weight groups: normal weight (BMI 18.5-25.0 kg/m[SUP]2[/SUP]), obese (BMI 30-40.0 kg/m[SUP]2[/SUP]), and morbidly obese (BMI ? 40 kg/m[SUP]2[/SUP]). To minimize confounding, we excluded patients with a history of smoking, alcoholism, or chronic wasting conditions, as suggested by the Global BMI Mortality Collaboration. To further isolate obesity from baseline differences across cohorts, we performed a three-way propensity matching analysis. The association between body weight and in-hospital all-cause 30-day mortality was assessed using Cox proportional hazard regression analysis.
Results: 132,965 influenza and 34,177 pneumonia hospitalizations were identified. For patients with influenza, obesity (hazard ratio
: 1.51; 95% CI: 1.01-2.26) and morbid obesity (HR: 1.64; 95% CI: 1.10-2.44) were associated with higher in-hospital 30-day mortality compared to normal weight. For pneumonia, obesity (HR, 0.41; 95% CI, 0.20-0.84) and morbid obesity (HR, 0.49; 95% CI, 0.25-0.96) were associated with reduced 30-day mortality compared to normal weight.
Conclusions and implications: Obesity may increase 30-day mortality risk during influenza hospitalization but provide mortality benefit in pneumonia, a divergent effect not adequately explained by lower admission threshold.
Keywords: Influenza; Morbid obesity; Mortality; Obesity; Pneumonia.