Impact of obesity on influenza compared to pneumonia hospitalization outcomes
Chen Wei1, Frank Qian2, Ye Liu3
1Harvard Medical School, Boston, MA, USA.
Objectives:
Previous literature has suggested that obesity impacts mortality risk differently in bacterial versus viral infections. This study sought to further elucidate this association in pneumonia versus influenza.
Design:
Retrospective cohort study.
Setting And Participants:
Data were collected from the US Nationwide Readmission Database from 2013 to 2014.
Methods:
Patients were categorized into three weight groups: normal weight (BMI 18.5-25.0 kg/m2), obese (BMI 30-40.0 kg/m2), and morbidly obese (BMI ≥ 40 kg/m2). To minimize confounding, we excluded patients with a history of smoking, alcoholism, or chronic wasting conditions, as suggested by the Global BMI Mortality Collaboration. To further isolate obesity from baseline differences across cohorts, we performed a three-way propensity matching analysis. The association between body weight and in-hospital all-cause 30-day mortality was assessed using Cox proportional hazard regression analysis.
Results:
132,965 influenza and 34,177 pneumonia hospitalizations were identified. For patients with influenza, obesity (hazard ratio [HR]: 1.51; 95% CI: 1.01-2.26) and morbid obesity (HR: 1.64; 95% CI: 1.10-2.44) were associated with higher in-hospital 30-day mortality compared to normal weight. For pneumonia, obesity (HR, 0.41; 95% CI, 0.20-0.84) and morbid obesity (HR, 0.49; 95% CI, 0.25-0.96) were associated with reduced 30-day mortality compared to normal weight.
Conclusions And Implications:
Obesity may increase 30-day mortality risk during influenza hospitalization but provide mortality benefit in pneumonia, a divergent effect not adequately explained by lower admission threshold.
More Related Videos
10:47Using Bioluminescent Imaging to Investigate Synergism Between Streptococcus pneumoniae and Influenza A Virus in Infant Mice
Published on: April 14, 2011
08:30Intraperitoneal Glucose Tolerance Test, Measurement of Lung Function, and Fixation of the Lung to Study the Impact of Obesity and Impaired Metabolism on Pulmonary Outcomes
Published on: March 15, 2018
Related Concept Videos
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:21Drug Dosing: Obese Patients
01:25Pharmacokinetics in Obese Patients: Drug Absorption and Distribution
01:24Obesity
01:20Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include: