Obesity paradox in advanced liver disease: obesity is associated with lower mortality in hospitalized patients with cirrhosis
Obesity paradox in advanced liver disease: obesity is associated with lower mortality in hospitalized patients with cirrhosis
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DOI：
10.1111/liv.13137
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发表时间：
2016-10-01
影响因子：
6.7
通讯作者：
Baffy, Gyorgy
中科院分区：
文献类型：
--
作者：
Karagozian, Raffi;Bhardwaj, Gaurav;Baffy, Gyorgy
背景和目的调查肥胖如何影响肝硬化患者的住院死亡率、住院时间 (LOS) 和费用。肥胖是一种日益严重的流行病，与多种并发症、发病率增加以及医疗保健的重大经济负担相关。尽管肥胖带来总体有害影响，但“肥胖悖论”被描述为肥胖患者与非肥胖患者在各种慢性疾病中的死亡率降低。方法分析 2012 年全国住院患者样本 (NIS)，其中包含来自 44 个州和 4378 家医院的数据。纳入了根据国际疾病分类 9 代码 571.2、571.5 571.6 确定的所有初次、二次或三级出院诊断为肝硬化的病例的数据。主要结局包括住院患者死亡率、LOS 和住院费用。肥胖作为死亡率的预测因子是通过预先确定的肥胖共病变量来定义的。结果总共纳入了 32,605 名患者。肥胖肝硬化患者的粗死亡率低于非肥胖肝硬化患者（2.7% vs 3.5%，P=0.02）。相比之下，中位 LOS 较长（4 天 vs 3 天，P
Background & AimsTo investigate how obesity impacts inpatient mortality, length of stay (LOS) and costs in patients with cirrhosis. Obesity is a growing epidemic associated with multiple co-morbidities, increased morbidity, and a significant economic burden on healthcare. Despite the overall harmful impact of obesity, the obesity paradox' has been described as decreased mortality among obese vs non-obese patients in various chronic medical conditions.MethodsAnalysis of the Nationwide Inpatient Sample (NIS) for 2012, which contains data from 44 states and 4378 hospitals. Data from all cases with primary, secondary or tertiary discharge diagnosis of cirrhosis identified by International Classification of Diseases-9 code 571.2, 571.5 571.6 were included. Primary outcomes included inpatient mortality, LOS, and hospital charges. Obesity as a predictor of mortality was defined by a predetermined obesity co-morbidity variable.ResultsA total of 32,605 patients were included. Crude mortality was lower for obese cirrhotic patients (2.7% vs 3.5%, P=0.02) than for non-obese cirrhotic patients. In contrast, median LOS was longer (4 vs 3days, P