242-LB: The Obesity Paradox among Patients Hospitalized for Diabetes and Its Complications: Outcomes of the Nationwide Inpatient Sample

Sorto, Maria Elena Padilla; Gomez, Trisha Marie A.; Edigin, Ehizogie; Xu, Jing; Yap, Sara Elizabeth T.

doi:10.2337/db20-242-lb

Cited by 5 publications

(8 citation statements)

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“…This cohort was further divided based on the presence of a secondary discharge diagnosis of obesity similar to prior NIS-based studies. [6][7][8][9]12,18,19 Both general codes for obesity, as well as body mass index (BMI)-specific codes in ICD-10, were combined to accurately account for patients with obesity. A BMI between 30.0 and 39.9 was classified as class I/II, whereas BMI 40.0 or greater was classified as class III obesity.…”

Section: Study Populationmentioning

confidence: 99%

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Obesity Impacts Hospitalizations for Bacterial Pneumonia

Abusalim¹,

Inegbenijie²

2022

Infect Dis Clin Pract

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BackgroundCommunity-acquired pneumonia is a significant cause of morbidity and mortality worldwide caused by a wide variety of micro-organisms, most commonly bacterial. The study aimed to compare the mortality rates and secondary complications of disease severity in obese and nonobese with bacterial pneumonia (bPNE).MethodsThis was an observational cohort study of the National Inpatient Sample. The primary outcome was inpatient mortality. The secondary outcomes included sepsis, septic shock, acute respiratory failure, pulmonary embolism, need for mechanical ventilation, length of hospital stay, and total hospital charges. The findings were analyzed and compared with nonobese patients.Results and interpretationPatients with obesity class I/II and class III, had lower odds of inpatient mortality (adjusted odds ratio [aOR], 0.77; 95% confidence interval [CI], 0.67–0.88; P < 0.001 and aOR, 0.73; 95% CI, 0.64–0.88; P < 0.001, respectively) compared with nonobese patients with bPNE. There was a decrease in odds of having sepsis (aOR, 0.81; 95% CI, 0.70–0.93; P = 0.004) and septic shock (aOR, 0.67; 95% CI, 0.49–0.92; P = 0.014) in patients with obesity class I/II as compared with nonobese patients.Patients with obesity class III were associated with higher odds of acute respiratory failure (aOR, 1.51; 95% CI, 1.46–1.58; P < 0.001), acute respiratory distress syndrome (aOR, 1.37; 95% CI, 1.13–1.66; P < 0.001), mechanical ventilation (aOR, 1.49; 95% CI, 1.36–1.64; P < 0.001), deep vein thrombosis (aOR, 1.34; 95% CI, 1.18–1.54; P < 0.001), pulmonary embolism (aOR, 1.42; 95% CI, 1.22–1.67; P < 0.001), as well as increased total hospital charges and length of hospital stay as compared with nonobese patients.ConclusionsBoth obesity class I/II and class III were found to be associated with lower odds of inpatient mortality in patients admitted with bPNE, the reported obesity paradox. Obesity continues to be associated with significantly increased health care utilization, which may have a long-term impact on the population if the trend toward a higher proportion of obese patients continues.

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Section: Study Populationmentioning

confidence: 99%

“…However, some studies show either similar or lower mortality in obese patients 6,7 . This phenomenon is termed the obesity paradox and has been described in several disease conditions 8–12 …”

mentioning

confidence: 98%

Obesity Impacts Hospitalizations for Bacterial Pneumonia

Abusalim¹,

Inegbenijie²

2022

Infect Dis Clin Pract

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“…The NIS provides data on racial distribution of the hospitalizations: Race, uniform coding: (1) White, (2) Black, (3) Hispanic, (4) Asian or Pacific Islander, (5) Native American, (6) other. We combined groups 4, 5, and 6 into "others", forming a modified racial grouping as employed in prior NIS based publications [16][17][18][19][20][21].…”

Section: Study Populationmentioning

confidence: 99%

Racial Disparities in Outcomes of Adults Hospitalized for Viral Pneumonia

Ojemolon

Trelles-Garcia

et al. 2020

Cureus

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Background Viral pneumonia is an important cause of respiratory morbidity and mortality. Cases of viral pneumonia are becoming increasingly more common as at-risk populations increase globally. We sought to highlight the racial distribution of hospitalized patients with viral pneumonia and compare their outcomes. Materials and methods Data were obtained from the Nationwide Inpatient Sample (NIS) for 2016 and 2017. The study involved adults who had a principal discharge diagnosis of viral pneumonia. The primary outcome analyzed was inpatient mortality. Secondary outcomes included the development of sepsis, septic shock, acute respiratory failure, acute respiratory distress syndrome, non-ST segment elevation myocardial infarction (NSTEMI), acute kidney failure, deep vein thrombosis, pulmonary embolism, cerebrovascular accident, need for mechanical ventilation, and use of vasopressors as well as mean length of hospitalization and mean total hospital charges. Results Blacks and Hispanics had lower inpatient mortality adjusted odds (aOR: 0.39, 95% CI = 0.229-0.662, p<0.001 and aOR: 0.55, 95% CI = 0.347-0.858, p=0.009, respectively) compared to Whites. Black and Hispanic patients were also found to have lower adjusted odds ratio of having acute respiratory failure (aOR: 0.54, 95% CI = 0.471-0.614, p<0.001, and 0.66, 95% CI = 0.576-0.753, p<0.001, respectively). Conclusion Black and Hispanic patients are at lower risk of adverse outcomes when compared to White patients with viral pneumonia.

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“…It encompasses both undernutrition or protein-energy malnutrition (PEM) and overnutrition, including obesity. Malnutrition has been reported to increase the risk of infection and impacts the hospital outcomes of various disease conditions [2][3][4][5][6][7][8][9]. The World Health Organization (WHO) estimates that 462 million adults have PEM [10].…”

Section: Introductionmentioning

confidence: 99%