Background Knee arthroplasty is one of the most common reasons for hospitalizations in the United States. Diabetes mellitus is thought to be associated with adverse perioperative outcomes. We sought to demonstrate the effect of comorbid diabetes on hospitalizations involving patients with knee osteoarthritis who had knee arthroplasty. Materials and methods Data was obtained from the Nationwide Inpatient Sample (NIS) for 2016 and 2017. ICD-10 codes were used to obtain a cohort of patient who were principally admitted for knee osteoarthritis who underwent knee arthroplasty. The patients were further divided according to diabetic status. The primary outcome compared inpatient mortality. Secondary outcomes included mean length of hospital stay, total hospital charges, presence of secondary diagnoses on discharge of acute kidney injury, surgical site infection, sepsis, thromboembolic events, non-ST segment elevation myocardial infarction (NSTEMI). Results Patients with diabetes mellitus had a lower adjusted odds ratio for mortality (aOR: 0.45 95% CI: 0.221-0.920, p = 0.029), with no significant difference in total hospital charges and length of hospital stay. Interestingly, patients with diabetes had lower odds of NSTEMI; 0.53 (95% CI: 0.369-0.750, p < 0.001) sepsis; 0.64 (95% CI: 0.449-0.924, p = 0.017) and DVT; 0.67 (95% CI: 0.546-0.822, p < 0.001). Conclusion Uncomplicated diabetes mellitus is not associated with adverse outcomes in patients hospitalized with knee osteoarthritis who had knee arthroplasty.

Obesity has long been considered a risk factor for individual morbidity and mortality for numerous cardiopulmonary diseases. However, multiple studies have shown that patients who are overweight or obese according to BMI have better inpatient outcomes in various sub populations of patients. The purpose of this study was to demonstrate the effect of obesity on outcomes of patients admitted for bacterial pneumonia. METHODS: Data were extracted from the Nationwide Inpatient Sample (NIS) Database for 2016 and 2017. The numbers in the database are weighted to optimize national estimates. Searches were done using ICD 10 codes. Hospitalizations involving adults with a principal diagnosis of bacterial pneumonia were included. This group was further categorized based on patients with obesity, defined as a BMI $30. Patients with principal diagnosis of viral or fungal pneumonia were excluded. The primary outcome was inpatient mortality. Multivariate logistic regression analysis was used to adjust for possible confounders. Secondary outcomes were Length of stay (LOS) and Total hospital Charge (THC). Multivariate linear regression analysis was used to adjust for possible confounders for the secondary outcomes. RESULTS: There were about 1,236,109 adult hospitalizations principally for bacterial pneumonia, of which 11.2% were obese by ICD 10 diagnostic code. The obese patients were younger (mean age 60.7 vs 69.7 years). In these patients hospitalized for bacterial pneumonia, females were more likely to be obese. A total of 32,380 inpatient mortality (2.62%) occurred in hospitalizations for bacterial pneumonia. After adjusting for age, sex, disease severity and race, the odds ratio (aOR) for mortality in obese patients compared with nonobese patients was 0.63 (95% CI: 0.562-0.702, p<0.001). However, obese patients had a mean adjusted increase in LOS of 0.3 days (95% CI: 0.27-0.39, p<0.001) and increase in THC of $3881 (95% CI: 3085-4676, p<0.001) compared nonobese patients. CONCLUSIONS: In adult patients hospitalized with a principal diagnosis of bacterial pneumonia, obese patients had a statistically lower mortality rate, suggesting the presence of the obesity paradox. More research needs to be done to determine the factors responsible for this recurrent phenomenon. CLINICAL IMPLICATIONS: Emphasizing the need for further research into the relationship of obesity and cardiopulmonary diseases.

Background: Obesity has long been considered a risk factor for individual morbidity and mortality for numerous cardiopulmonary diseases. However, multiple studies have shown that patients who are overweight or obese according to BMI have better inpatient outcomes. Objective: To demonstrate the effect of obesity on outcomes of patients admitted for diabetes with and without complications. Method: Data were extracted from the Nationwide Inpatient Sample (NIS) Database for 2016 and 2017. The numbers in the database are weighted to optimize national estimates. Hospitalizations involving all adults with a principal diagnosis of type 1 and type 2 DM were included. This group was further categorized based on the presence of obesity, defined as BMI &gt;30, as a secondary diagnosis. The primary outcome was inpatient mortality and secondary outcomes were Length of stay (LOS) and Total hospital Charge (THC). Multivariate regression analysis was used to adjust for possible confounders. Results: Around 1,031,009 hospitalizations had a principal diagnosis of DM types 1 and 2. This group had a prevalence of 15.67% of obesity as a secondary diagnosis. Inpatient mortality occurred in 6285 cases (0.61%). After accounting for age, sex, disease severity and type of diabetes, the adjusted odds ratio (aOR) for mortality in obese patients was 0.63 (95% CI: 0.526 - 0 .762, p&lt; 0.001) compared to non-obese patients. Obese patients however, had adjusted increase in THC of $560 (95% CI: -347 - 1467, p=0.226) and adjusted increase in LOS of 0.3 days (95% CI: 0.3 - 0.4, p&lt;0.001). Conclusions: In patients hospitalized with a principal diagnosis of diabetes and its complications, obese patients had a statistically lower mortality rate. Hence, there seems to be growing evidence for the obesity paradox. More research needs to be done to determine the factors responsible for this recurrent phenomenon. Disclosure H. Shaka: None. M. Padilla Sorto: None. T.A. Gomez: None. E. Edigin: None. J. Xu: None. S.T. Yap: None.

The prevalence of obesity is rising in the American population generally, and this trend has not spared the population with primary lung malignancies. Multiple studies have shown that patients who are overweight or obese according to BMI have better inpatient outcomes in various sub populations of patients, including those with lung cancer. The aim of this study was to determine the effect of obesity on outcomes of patients with primary bronchial and lung cancers. METHODS: We extracted data from the Nationwide Inpatient Sample (NIS) Database for 2016 and 2017. The numbers in the database are weighted to optimize national estimates. Searches were done using ICD 10 codes. Hospitalizations involving adults with primary bronchial and lung malignancies were included. This group was further categorized based on patients with obesity, defined as a BMI $30. Patients with secondary metastatic disease to the lungs were excluded. The primary outcome was inpatient mortality. Multivariate logistic regression analysis was used to adjust for possible confounders. Secondary outcomes were Length of stay (LOS) and Total hospital Charge (THC). Multivariate linear regression analysis was used to adjust for possible confounders for the secondary outcomes. RESULTS: There were about 798,070 adult hospitalizations involving patients with bronchial and lung cancers, of which 6.1% were obese by ICD 10 diagnostic code. The obese patients were younger (mean age 66.5 vs 69.1 years) and had a female predominance. A total of 70175 inpatient mortality (8.96%) occurred in hospitalizations involving patients with these cancers. After adjusting for age, sex, disease severity and race, the odds ratio (aOR) for mortality in obese patients compared with nonobese patients was 0.68 (95% CI: 0.624-0.744, p<0.001). However, obese patients had a mean adjusted increase in LOS of 0.6 days (95% CI: 0.44-0.68, p<0.001) and increase in THC of $10337 (95% CI: 8541-12133, p<0.001) compared nonobese patients with bronchial and lung cancers. CONCLUSIONS: Among adults hospitalized with a diagnosis of bronchogenic malignancies, obese patients had a statistically lower mortality rate, adding to the growing evidence of the obesity paradox in this population. More research needs to be done to elucidate the factors responsible for this recurrent phenomenon. CLINICAL IMPLICATIONS: Emphasizing the need for further research into the relationship of obesity and lung malignancies.

No abstract