Interaction of obesity and infections

Dhurandhar, Nikhil V.; Bailey, Dylan; Thomas, Diana M.

doi:10.1111/obr.12320

Cited by 144 publications

(119 citation statements)

References 214 publications

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“…Given that patients with higher BMI have a reduced response to prophylaxis, adjustments of drug doses may also be considered. 48 Our study has several limitations. First, the major limitation of the study is the lack of actual health care cost data.…”

Section: Discussionmentioning

confidence: 91%

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Severe Obesity Is Associated With Increased Risk of Early Complications and Extended Length of Stay Following Coronary Artery Bypass Grafting Surgery

Terada

Johnson

Norris

et al. 2016

JAHA

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BackgroundBetter understanding of the relationship between obesity and postsurgical adverse outcomes is needed to provide quality and efficient care. We examined the relationship of obesity with the incidence of early adverse outcomes and in‐hospital length of stay following coronary artery bypass grafting surgery.Methods and ResultsWe analyzed data from 7560 patients who underwent coronary artery bypass grafting. Using body mass index (BMI; in kg/m2) of 18.5 to 24.9 as a reference, the associations of 4 BMI categories (25.0–29.9, 30.0–34.9, 35.0–39.9, and ≥40.0) with rates of operative mortality, overall early complications, subgroups of early complications (ie, infection, renal and pulmonary complications), and length of stay were assessed while adjusting for clinical covariates. There was no difference in operative mortality; however, higher risks of overall complications were observed for patients with BMI 35.0 to 39.9 (adjusted odds ratio 1.35, 95% CI 1.11–1.63) and ≥40.0 (adjusted odds ratio 1.56, 95% CI 1.21–2.01). Subgroup analyses identified obesity as an independent risk factor for infection (BMI 30.0–34.9: adjusted odds ratio 1.60, 95% CI 1.24–2.05; BMI 35.0–39.9: adjusted odds ratio 2.34, 95% CI 1.73–3.17; BMI ≥40.0: adjusted odds ratio 3.29, 95% CI 2.30–4.71). Median length of stay was longer with BMI ≥40.0 than with BMI 18.5 to 24.9 (median 7.0 days [interquartile range 5 to 10] versus 6.0 days [interquartile range 5 to 9], P=0.026).Conclusions BMI ≥40.0 was an independent risk factor for longer length of stay, and infection was a potentially modifiable risk factor. Greater perioperative attention and intervention to control the risks associated with infection and length of stay in patients with BMI ≥40.0 may improve patient care quality and efficiency.

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Section: Discussionmentioning

confidence: 91%

“…Concerted efforts to reduce the incidence of infection and perioperative blood glucose are likely to be effective in reducing prolonged LOS and associated costs. Given that patients with higher BMI have a reduced response to prophylaxis, adjustments of drug doses may also be considered …”

Section: Discussionmentioning

confidence: 99%

Severe Obesity Is Associated With Increased Risk of Early Complications and Extended Length of Stay Following Coronary Artery Bypass Grafting Surgery

Terada

Johnson

Norris

et al. 2016

JAHA

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“…The worldwide prevalence of obesity more than doubled between 1980 and 2014. Obesity is associated with infectious diseases, such that certain infections may trigger an increase in adiposity, such as human adenovirus 36, H1N1/influenza virus, human immunodeficiency virus, and Helicobacter pylori ( H. pylori )[1]. …”

Section: Introductionmentioning

confidence: 99%

“…Other studies have reported a higher H. pylori prevalence in obese patients[7,8]. The systematic review by Dhurandhar et al[1] reported an increase in weight gain or an increase in the biomarkers associated with weight gain after H. pylori eradication, and most cross-sectional studies found evidence of a higher prevalence of H. pylori infection in obese individuals or metabolic impairment in the presence of the infection.…”

Section: Introductionmentioning

confidence: 99%

Association of obesity withHelicobacter pyloriinfection: A retrospective study

Liu

Yuan

et al. 2017

WJG

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AIMTo explore the association between Helicobacter pylori (H. pylori) infection and obesity/weight gain in a Chinese population.METHODSOur primary outcome was the change in body mass index (BMI). The generalized linear models were used to explore the association between H. pylori infection and the change of BMI, and the logistic regression models were used to explore the association between H. pylori infection and obesity.RESULTSA total of 3039 subjects were recruited and analyzed, of which 12.8% were obese. The prevalence of H. pylori infection was 53.9% (1639/3039) overall and 54.6% (212/388) in the obese subjects. The change of BMI in the H. pylori (+) group was not significantly higher than that in the H. pylori (-) group after adjustment for potential confounding factors [RR = 0.988, 95%CI: 0.924-1.057, P = 0.729]. The prevalence of obesity decreased 1.1% in the H. pylori (+) group and 0.5% in the H. pylori (-) group. The RR of H. pylori infection for obesity was 0.831 (95%CI: 0.577-1.197, P = 0.321) after the adjustment.CONCLUSIONH. pylori infection was not associated with overweight/obesity observed from the retrospective study in this Chinese population.

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“…In the general population, obesity has been associated with an increased risk of both bacterial and viral infections, at several body sites, and nosocomial and surgical site infections . Obese patients are also more likely to get more severe infections than their nonobese counterparts, and carry poorer prognosis with higher risk of resistance to treatment . This increased infection risk is probably attributable to metabolically active visceral fat, as opposed to subcutaneous fat.…”

mentioning

confidence: 99%