The utility of the Edmonton Obesity Staging System for the prediction of COVID-19 outcomes: a multi-centre study

Rodríguez-Flores, Marcela; Goicochea-Turcott, Eduardo W.; Mancillas-Adame, Leonardo; Garibay-Nieto, Nayely; López-Cervantes, Malaquı́as; Rojas-Russell, Mario; Castro-Porras, Lilia; Gutiérrez-León, Eduardo; Campos-Calderón, Luis Fernando; Pedraza-Escudero, Karen; Aguilar-Cuarto, Karina; Villanueva-Ortega, Eréndira; Hernández-Ruiz, Joselín; Guerrero‐Avendaño, Guadalupe; Monzalvo-Reyes, Sheyla M.; García-Rascón, Rafael; Gil-Velázquez, Israel N.; Cortés-Hernández, Dora E.; Granados-Shiroma, Marcela; Alvarez-Rodríguez, Brenda G.; Garza, Martha Leticia Cabello; González-Contreras, Zaira L.; Palencia, Esteban Picazzo; Cerda-Arteaga, Juana M.; Pérez-Gómez, Héctor Raúl; Calva-Rodríguez, R; Sánchez-Rodríguez, Gerardo; Carpio-Vázquez, Leslie D.; Dávalos-Herrera, María A.; Villatoro-de-Pleitez, Karla M.; Suárez-López, Melissa D.; Nevárez-Carrillo, María G.; Pérez-Alcántara, Karina; Mehta, Roopa; Diez, Edurne Sandoval; Gregg, Edward W.

doi:10.1038/s41366-021-01017-8

Cited by 9 publications

(9 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Increased rates of AKI in this population may mediate the association between EOSS stage and poor clinical outcomes as AKI itself has been shown to be a strong predictor of in-hospital mortality and other poor outcomes in COVID-19. Our study corroborates recently published data from Mexico 29 utilizing EOSS to comprehensively assess obesity-related comorbidity burden in COVID-19 patients with elevated BMI. These analyses demonstrated that obesity-related comorbidity burden, as assessed by EOSS, was associated with poor COVID-19 outcomes, unlike BMI.…”

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

Comparing body mass index and obesity‐related comorbidities as predictors in hospitalized COVID‐19 patients

et al. 2022

View full text Add to dashboard Cite

The association between body mass index (BMI) and poor COVID-19 outcomes in patients has been demonstrated across numerous studies. However, obesity-related comorbidities have also been shown to be associated with poor outcomes. The purpose of this study was to determine whether BMI or obesity-associated comorbidities contribute to elevated COVID-19 severity in non-elderly, hospitalized patients with elevated BMI (≥25 kg/m 2 ). This was a single-center, retrospective cohort study of 526 hospitalized, non-elderly adult (aged 18-64) COVID-19 patients with BMI ≥25 kg/m 2 in suburban New York from March 6 to May 11, 2020. The Edmonton Obesity Staging System (EOSS) was used to quantify the severity of obesity-related comorbidities. EOSS was compared with BMI in multivariable regression analyses to predict COVID-19 outcomes. We found that higher EOSS scores were associated with poor outcomes after demographic adjustment, unlike BMI. Specifically, patients with increased EOSS scores had increased odds of acute kidney injury (adjusted odds ratio [aOR] = 6.40; 95% CI 3.71-11.05), intensive care unit admission (aOR = 10.71;, mechanical ventilation (aOR = 3.10; 95% CI 2.01-4.78) and mortality (aOR = 5.05; 95% CI 1.83-13.90). Obesity-related comorbidity burden as determined by EOSS was a better predictor of poor COVID-19 outcomes relative to BMI, suggesting that comorbidity burden may be driving risk in those hospitalized with elevated BMI.

show abstract

Section: Discussionsupporting

confidence: 90%

“…Our study corroborates recently published data from Mexico 29 utilizing EOSS to comprehensively assess obesity‐related comorbidity burden in COVID‐19 patients with elevated BMI. These analyses demonstrated that obesity‐related comorbidity burden, as assessed by EOSS, was associated with poor COVID‐19 outcomes, unlike BMI.…”

Section: Discussionsupporting

confidence: 89%

Comparing body mass index and obesity‐related comorbidities as predictors in hospitalized COVID‐19 patients

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Although medical, and functional status and a complex social milieu are known to mediate health outcomes, traditional anthropometric measurements often remain the sole aspects that guide the treatment of individuals with obesity 28 . The EOSS‐P provides a systematic way to shift the narrative from weight loss toward treatment based on the individual pathophysiology and needs of persons with obesity 29 . To do this, investment in systems that support prospective data capture and scoring in the real‐world setting are required.…”

Section: Discussionmentioning

confidence: 99%

More than just body mass index: Using the Edmonton obesity staging system for pediatrics to define obesity severity in a multi‐ethnic Australian pediatric clinical cohort

Southcombe

Vivekanandarajah

Krstic

et al. 2022

Obesity Science & Practice

View full text Add to dashboard Cite

Background Despite advancements in the use of body mass index (BMI) to categorize obesity severity in pediatrics, its utility in guiding individual clinical decision making remains limited. The Edmonton Obesity Staging System for Pediatrics (EOSS‐P) provides a way to categorize the medical and functional impacts of obesity according to the severity of impairment. The aim of this study was to describe the severity of obesity among a sample of multicultural Australian children using both BMI and EOSS‐P tools. Methods This cross‐sectional study included children aged 2–17 years receiving obesity treatment through the Growing Health Kids (GHK) multi‐disciplinary weight management service in Australia between January to December 2021. BMI severity was determined using the 95th percentile for BMI on age and gender standardized Centre for Disease Control and Prevention (CDC) growth charts. The EOSS‐P staging system was applied across the four health domains (metabolic, mechanical, mental health and social milieu) using clinical information. Results Complete data was obtained for 338 children (age 10.0 ± 3.66 years), of whom 69.5% were affected by severe obesity. An EOSS‐P stage 3 (most severe) was assigned to 49.7% of children, the remaining 48.5% were assigned stage 2 and 1.5% were assigned stage 1 (least severe). BMI predicted health risk as defined by EOSS‐P overall score. BMI class did not predict poor mental health. Conclusion Used in combination, BMI and EOSS‐P provide improved risk stratification of pediatric obesity. This additional tool can help focus resources and develop comprehensive multidisciplinary treatment plans.

show abstract

“…This 5-stage system integrates metabolic, physical, functional, mental health, and psychological parameters to assess the severity of obesity and guide treatment. It is a better predictor of all-cause mortality and COVID-19 outcomes than BMI or waist circumference alone [55, 69, 70] and is feasible to calculate quickly and easily from standard medical records [71]. A full description and supporting evidence for assessment recommendations are available at asoi.info/guidelines/assessment.…”

Section: Recommendationsmentioning

confidence: 99%

Obesity in Adults: A 2022 Adapted Clinical Practice Guideline for Ireland

et al. 2022

View full text Add to dashboard Cite

Background: This Clinical Practice Guideline (CPG) for the management of obesity in adults in Ireland, adapted from the Canadian CPG, defines obesity as a complex chronic disease characterised by excess or dysfunctional adiposity that impairs health. The guideline reflects substantial advances in the understanding of the determinants, pathophysiology, assessment, and treatment of obesity. Summary: It shifts the focus of obesity management toward improving patient-centred health outcomes, functional outcomes, and social and economic participation, rather than weight loss alone. It gives recommendations for care that are underpinned by evidence-based principles of chronic disease management; validate patients’ lived experiences; move beyond simplistic approaches of “eat less, move more” and address the root drivers of obesity. Key Messages: People living with obesity face substantial bias and stigma, which contribute to increased morbidity and mortality independent of body weight. Education is needed for all healthcare professionals in Ireland to address the gap in skills, increase knowledge of evidence-based practice, and eliminate bias and stigma in healthcare settings. We call for people living with obesity in Ireland to have access to evidence-informed care, including medical, medical nutrition therapy, physical activity and physical rehabilitation interventions, psychological interventions, pharmacotherapy, and bariatric surgery. This can be best achieved by resourcing and fully implementing the Model of Care for the Management of Adult Overweight and Obesity. To address health inequalities, we also call for the inclusion of obesity in the Structured Chronic Disease Management Programme and for pharmacotherapy reimbursement, to ensure equal access to treatment based on health-need rather than ability to pay.

show abstract

The utility of the Edmonton Obesity Staging System for the prediction of COVID-19 outcomes: a multi-centre study

Cited by 9 publications

References 38 publications

Comparing body mass index and obesity‐related comorbidities as predictors in hospitalized COVID‐19 patients

Comparing body mass index and obesity‐related comorbidities as predictors in hospitalized COVID‐19 patients

More than just body mass index: Using the Edmonton obesity staging system for pediatrics to define obesity severity in a multi‐ethnic Australian pediatric clinical cohort

Obesity in Adults: A 2022 Adapted Clinical Practice Guideline for Ireland

Contact Info

Product

Resources

About