Obesity and outcomes in patients hospitalized with pneumonia.
Obesity and outcomes in patients hospitalized with pneumonia.
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DOI：
10.1111/j.1469-0691.2012.04003.x
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发表时间：
2013-08
期刊：
影响因子：
--
通讯作者：
Majumdar SR
中科院分区：
文献类型：
--
作者：
Kahlon S;Eurich DT;Padwal RS;Malhotra A;Minhas-Sandhu JK;Marrie TJ;Majumdar SR
研究表明，肥胖与肺炎患者更好的预后存在着矛盾的关系。因此，我们研究了肥胖对肺炎住院患者短期死亡率的影响。两年来，我们前瞻性地收集了加拿大艾伯塔省埃德蒙顿六家医院连续收治的所有患有肺炎的成人的临床和放射学数据。我们还收集了 907 名患者的体重指数（BMI，kg/m2），并将他们分为体重不足（BMI < 18.5）、正常（18.5 至 <25）、超重（25 至 <30）和肥胖（> 30）。总体而言，65% 的人年龄 >65 岁，52% 是女性，15% 的人最近体重减轻。 84 人 (9%) 体重不足，358 人 (39%) 体重正常，228 人 (25%) 超重，237 人 (26%) 肥胖。三分之二的患者患有严重肺炎（63% PSI IV/V 级），79 名患者 (9%) 死亡。与正常人 (36 [10%])、超重 (21 [9%]) 或肥胖 (10 [4%]，趋势 p <0.001) 相比，体重不足 (12 [14%]) 的院内死亡率最高。多变量逻辑回归分析显示，与体重正常的患者相比，肥胖患者的院内死亡率显着降低：调整后的比值比（OR）为0.46； 95% CI，0.22–0.97； p 0.04。然而，与体重正常的患者相比，体重不足（调整后 OR，1.13；95% CI，0.54-2.4；p < 0.7）和超重（调整后 OR，0.94；95% CI，0.52-1.69；p < 0.8）均与院内死亡率无关。总之，在因肺炎住院的患者中，肥胖与较低的短期死亡率独立相关，而体重不足或超重均不相关。这表明体重指数 > 30 kg/m2 具有保护性影响，需要更好的机制理解。
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/m2) 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/m2 that requires better mechanistic understanding.
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影响因子：
16.2
作者：
McAlister, FA;Majumdar, SR;Marrie, TJ
通讯作者：
Marrie, TJ
影响因子：
--
作者：
Baik, I;Curhan, GC;Fawzi, WW
通讯作者：
Fawzi, WW
影响因子：
1.6
作者：
Johnstone, Jennie;Eurich, Dean T.;Marrie, Thomas J.
通讯作者：
Marrie, Thomas J.
影响因子：
158.5
作者：
Malhotra, Atul
通讯作者：
Malhotra, Atul
影响因子：
158.5
作者：
Fine, MJ;Auble, TE;Kapoor, WN
通讯作者：
Kapoor, WN