Document Detail


Obesity and outcomes in patients hospitalized with pneumonia.
MedLine Citation:
PMID:  22963453     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Studies suggest obesity is paradoxically associated with better outcomes for patients with pneumonia. Therefore, we examined the impact of obesity on short-term mortality in patients hospitalized with pneumonia. For 2 years clinical and radiographic data were prospectively collected on all consecutive adults admitted with pneumonia to six hospitals in Edmonton, Alberta, Canada. We identified 907 patients who also had body mass index (BMI, kg/m(2)) collected and categorized them as underweight (BMI < 18.5), normal (18.5 to <25), overweight (25 to <30) and obese (>30). Overall, 65% were >65 years, 52% were female, and 15% reported recent weight loss. Eighty-four (9%) were underweight, 358 (39%) normal, 228 (25%) overweight, and 237 (26%) obese. Two-thirds had severe pneumonia (63% PSI Class IV/V) and 79 (9%) patients died. In-hospital mortality was greatest among those that were underweight (12 [14%]) compared with normal (36 [10%]), overweight (21 [9%]) or obese (10 [4%], p <0.001 for trend). Compared with those of normal weight, obese patients had significantly lower rates of in-hospital mortality in multivariable logistic regression analyses: adjusted odds ratio (OR), 0.46; 95% CI, 0.22-0.97; p 0.04. However, compared with patients with normal weight, neither underweight (adjusted OR, 1.13; 95% CI, 0.54-2.4; p 0.7) nor overweight (adjusted OR, 0.94; 95% CI, 0.52-1.69; p 0.8) were associated with in-hospital mortality. In conclusion, in patients hospitalized with pneumonia, obesity was independently associated with lower short-term mortality, while neither being underweight nor overweight were. This suggests a protective influence of BMIs > 30 kg/m(2) that requires better mechanistic understanding.
Authors:
S Kahlon; D T Eurich; R S Padwal; A Malhotra; J K Minhas-Sandhu; T J Marrie; S R Majumdar
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-09-11
Journal Detail:
Title:  Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases     Volume:  19     ISSN:  1469-0691     ISO Abbreviation:  Clin. Microbiol. Infect.     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-07-16     Completed Date:  2014-01-27     Revised Date:  2014-02-04    
Medline Journal Info:
Nlm Unique ID:  9516420     Medline TA:  Clin Microbiol Infect     Country:  France    
Other Details:
Languages:  eng     Pagination:  709-16     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Alberta
Body Mass Index
Cohort Studies
Female
Hospitalization
Humans
Male
Middle Aged
Obesity / complications*
Pneumonia / drug therapy*,  mortality*
Prospective Studies
Survival Analysis
Treatment Outcome
Grant Support
ID/Acronym/Agency:
K24 HL093218/HL/NHLBI NIH HHS; P01 HL095491/HL/NHLBI NIH HHS; R01 HL085188/HL/NHLBI NIH HHS; R01 HL090897/HL/NHLBI NIH HHS; //Canadian Institutes of Health Research
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