Association between body mass index and in-hospital outcomes

Akinyemiju, Tomi; Meng, Qingrui; Vin-Raviv, Neomi

doi:10.1097/md.0000000000004189

Cited by 37 publications

(34 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is most likely that the healthcare system will continue to care for large numbers of patients with obesity and diabetes mellitus, and thus hospitals should be prepared to successfully manage DFUs/DFIs. Previous reports suggest that diabetes mellitus does not contribute to increased morbidity or mortality in hospitalized obese patients , but higher body mass index (BMI) has been associated with increased in‐patient mortality . To our knowledge, no study at the national level has addressed specifically the impact of morbid obesity on outcomes among hospitalized patients with DFUs/DFIs.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes among morbidly obese patients hospitalized with diabetic foot complications

Harris¹,

Abougergi

Wright³

2018

Clinical Obesity

View full text Add to dashboard Cite

Summary The aim of the study is to investigate effects of morbid obesity on patients hospitalized with diabetic foot ulcers and infections (DFU/Is). This retrospective cohort study of hospitalized adults investigated patients with a principal diagnosis of DFU/Is, and compared outcomes based on weight. The primary outcome was lower limb amputations. Secondary outcomes included in‐hospital mortality, morbidity (sepsis and discharge disposition), resource utilization (length of stay [LOS] and total hospitalization charges). Multivariate analyses adjusted for confounders. A total of 31 730 admissions were included; 14% were morbidly obese. Patients with morbid obesity had overall lower rates of amputations (adjusted odds ratio [aOR]: 0.60; 95% confidence interval [CI]: 0.45–0.80). There was no difference in mortality rates between those who were morbidly obese and the non‐morbidly obese patients (aOR: 3.89 [95% CI: 0.79–19.30]). Combined data from 2010 to 2014 have found higher odds of sepsis in morbidly obese patients compared with non‐morbidly obese patients after adjusting for confounders (aOR: 1.49 [1.09–2.02], P = 0.01). Patients with morbid obesity were less likely to be discharged to home (aOR: 0.82 [95% CI: 0.70–0.95]), had longer LOS (adjusted mean difference [aMD]: 0.47 [95% CI: 0.13–0.81]) and higher hospital charges (aMD: $3205 [95% CI: $3373–$6037]). Despite having lower amputation rates compared to those who are not morbidly obese, patients with morbid obesity hospitalized for DFU/Is succumbed to sepsis more frequently and had less favourable utilization metrics. Specialized care pathways may be needed to enhance the value of care delivered to this high‐risk population.

show abstract

Section: Introductionmentioning

confidence: 99%

Clinical outcomes among morbidly obese patients hospitalized with diabetic foot complications

Harris¹,

Abougergi

Wright³

2018

Clinical Obesity

View full text Add to dashboard Cite

show abstract

“…When the study population was further divided according to BMI categories (normal weight, overweight and obese), subjects with obesity showed higher hospital and ICU length of stay. Previous reports on hospitalized patients observed that higher BMI is associated with increased morbidity and LOS [19,20], which is one of the major determinants of hospital costs [21].…”

Section: Discussionmentioning

confidence: 98%

“…Coronavirus disease 2019 (COVID- 19), caused by SARS-CoV-2 infection, includes a spectrum of illness; from asymptomatic infection [1] to severe pneumonia characterized by acute respiratory injury in about 20% of patients presented for medical care [2]. The risk factors associated with disease severity included increased age, diabetes, immune suppression and organ failure [2].…”

Section: Introductionmentioning

confidence: 99%

Obesity as a risk factor for unfavourable outcomes in critically ill patients affected by Covid-19 related respiratory failure: clinical relevance and potential pathophysiological mechanism.

Rossi

Gottin

Donadello

et al. 2020

Preprint

View full text Add to dashboard Cite

Abstract Background/Objectives: Recent studies show that obesity is a risk factor for hospital admission and for critical care need in patients with coronavirus disease 2019 (COVID-19).The aim was to determine whether obesity is a risk factor for unfavourable health outcomes in patients affected by COVID-19 admitted to ICU and to compare the observed trend of C-Reactive Protein (CRP) and Creatine Phosphokinase (CPK), as potential pathophysiological mechanisms linking disease severity with Body Mass Index (BMI).Subjects/Methods: 95 consecutive patients with COVID-19 (78 males and 18 females) were admitted to ICU and included in the study. Height, weight, BMI, Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, CRP, CPK, as well as ICU and hospital length of stay and comorbidities were evaluated. Results: Participants with obesity had a lower 28 day survival rate from ICU admission than normal weight subjects. Cox proportional hazard model-derived estimates, adjusted for age, gender and comorbidity, confirmed the results of the survival analysis (HR:5.30,95%C.I.1.26-22.34). In the full adjusted model, age was independently associated with mortality (HR:1.13,95%C.I:1.05-1.21).Obese subjects showed longer hospital and ICU stay as compared with normal weight counterpart.Subjects with obesity showed significantly higher CRP and CPK levels than normal weight subjects.Conclusions: Our study shows that in COVID-19 subjects admitted to ICU obesity is a risk factor for unfavourable health outcomes with higher mortality and longer hospital stay. The increase in CRP and CPK levels observed in this population could at least in part explain the unfavourable outcomes observed in individuals with obesity. In those subjects, careful management of any medical signs or symptoms and prompt intervention in case of suspected SARS-CoV-2 infection is necessary to prevent the progression of the disease towards severe outcomes and the increase of hospital treatment costs.

show abstract

“…A study from Scotland reported that underweight and obesity are associated with higher number of days spent in hospital over a 20‐year period . A large study indicated that in hospitalized patients, obesity is associated with higher mortality risk and longer hospital stay …”

Section: Introductionmentioning

confidence: 99%