Obesity and risk of subsequent hospitalisation with pneumonia

Abstract

Obesity may be associated with increased risk of pneumonia, but available data on this relationship are sparse and inconsistent.We followed a prospective cohort of 22,578 males and 25,973 females from the Danish Diet, Cancer and Health Study, aged 50-64 yrs and free from major chronic diseases at baseline (1993)(1994)(1995)(1996)(1997), for first-time hospitalisation with pneumonia (median follow-up 12 yrs).Compared with males of normal weight, adjusted hazard ratios (HRs) for pneumonia were 1.4 (95% CI 1.2-1.7) for males with moderate obesity (body mass index (BMI) 30.0-34.9 kg?m -2 ), and 2.0 (95% CI 1.4-2.8) for males with severe obesity (BMI o35.0 kg?m -2 ), controlling for lifestyle and educational variables. Among females the associations were weaker, with adjusted HRs of 0.8 (95% CI 0.6-1.0) for moderate obesity, and 1.2 (95% CI 0.8-1.6) for severe obesity. Adjustment for major chronic diseases diagnosed during follow-up eliminated the associations between obesity and pneumonia risk. Obesity is associated with higher risk of hospitalisation with pneumonia among males but not among females, which is apparently explained by occurrence of other chronic diseases.

Alcohol drinking and risk of subsequent hospitalisation with pneumonia

“…The study has been described in detail elsewhere [20,21]. Eligible participants were aged 50-64 yrs, were born in Denmark, were residents of Copenhagen or Aarhus (both Denmark) and did not have a record of cancer in the Danish Cancer Registry.…”

To the Editors:

“…Concerning hyperglycaemia, we observed that 17% of severely obese versus only 1% of normal-weight participants in our study developed new uncomplicated diabetes during followup, and 6% versus 0.3%, respectively, developed complicated diabetes. Development of any comorbidity was a strong predictor of subsequent pneumonia in our cohort (hazard ratio (HR) 4.4 (95% CI 4.0-4.8) for a Charlson comorbidity index score of 1-2, and HR 11.5 (95% CI 9.4-14.2) for a Charlson index score of o3), and associations between baseline obesity and pneumonia risk vanished when adjusting for subsequent comorbidity [1]. Diabetes is known to increase pneumonia risk by 25-75%, particularly when long-term glycaemic control is poor [2].…”

“…We thank our colleagues for their interest in our recent study in the European Respiratory Journal on the risk of pneumonia hospitalisation in obese individuals [1].…”

The Effects of Obesity on the Comparative Effectiveness of Linezolid and Vancomycin in Suspected Methicillin-Resistant Staphylococcus aureus Pneumonia

“…Decreased immunity, a higher risk of aspiration, reduced lung volume, and an altered ventilation pattern, impact pneumonia risk in obese patients [5,6]. Furthermore, obesity itself is an independent predictor of antibiotic treatment failure [16].…”

“…Obesity is associated with an increased risk of pneumonia [5,6]. Decreased immunity, a higher risk of aspiration, reduced lung volume, and an altered ventilation pattern, impact pneumonia risk in obese patients [5,6].…”