Relationship between Body Mass Index and Outcomes among Hospitalized Patients with Community-Acquired Pneumonia

Anna M. Bramley, Carrie Reed, Lyn Finelli, Wesley H. Self, Krow Ampofo, Sandra Arnold, Derek J. Williams, Carlos G. Grijalva, Evan J. Anderson, Chris Stockmann, Christopher Trabue, Sherene Fakhran, Robert Balk, Jonathan Mccullers, Andrew T. Pavia, Kathryn M. Edwards, Richard G. Wunderink, Seema Jain

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background. The effect of body mass index (BMI) on community-acquired pneumonia (CAP) severity is unclear. Methods. We investigated the relationship between BMI and CAP outcomes (hospital length of stay [LOS], intensive care unit [ICU] admission, and invasive mechanical ventilation) in hospitalized CAP patients from the Centers for Disease Control and Prevention Etiology of Pneumonia in the Community (EPIC) study, adjusting for age, demographics, underlying conditions, and smoking status (adults only). Results. Compared with normal-weight children, odds of ICU admission were higher in children who were overweight (adjusted odds ratio [aOR], 1.7; 95% confidence interval [CI], 1.1-2.8) or obese (aOR, 2.1; 95% CI, 1.4-3.2), and odds of mechanical ventilation were higher in children with obesity (aOR, 2.7; 95% CI, 1.3-5.6). When stratified by asthma (presence/absence), these findings remained significant only in children with asthma. Compared with normal-weight adults, odds of LOS >3 days were higher in adults who were underweight (aOR, 1.6; 95% CI, 1.1-2.4), and odds of mechanical ventilation were lowest in adults who were overweight (aOR, 0.5; 95% CI,.3-.9). Conclusions. Children who were overweight or obese, particularly those with asthma, had higher odds of ICU admission or mechanical ventilation. In contrast, adults who were underweight had longer LOS. These results underscore the complex relationship between BMI and CAP outcomes.

Original languageEnglish (US)
Pages (from-to)1873-1882
Number of pages10
JournalJournal of Infectious Diseases
Volume215
Issue number12
DOIs
StatePublished - Jun 15 2017

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Pneumonia
Body Mass Index
Artificial Respiration
Odds Ratio
Confidence Intervals
Length of Stay
Intensive Care Units
Asthma
Thinness
Weights and Measures
Pediatric Obesity
Centers for Disease Control and Prevention (U.S.)
Smoking
Demography

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Infectious Diseases

Cite this

Relationship between Body Mass Index and Outcomes among Hospitalized Patients with Community-Acquired Pneumonia. / Bramley, Anna M.; Reed, Carrie; Finelli, Lyn; Self, Wesley H.; Ampofo, Krow; Arnold, Sandra; Williams, Derek J.; Grijalva, Carlos G.; Anderson, Evan J.; Stockmann, Chris; Trabue, Christopher; Fakhran, Sherene; Balk, Robert; Mccullers, Jonathan; Pavia, Andrew T.; Edwards, Kathryn M.; Wunderink, Richard G.; Jain, Seema.

In: Journal of Infectious Diseases, Vol. 215, No. 12, 15.06.2017, p. 1873-1882.

Research output: Contribution to journalArticle

Bramley, AM, Reed, C, Finelli, L, Self, WH, Ampofo, K, Arnold, S, Williams, DJ, Grijalva, CG, Anderson, EJ, Stockmann, C, Trabue, C, Fakhran, S, Balk, R, Mccullers, J, Pavia, AT, Edwards, KM, Wunderink, RG & Jain, S 2017, 'Relationship between Body Mass Index and Outcomes among Hospitalized Patients with Community-Acquired Pneumonia', Journal of Infectious Diseases, vol. 215, no. 12, pp. 1873-1882. https://doi.org/10.1093/infdis/jix241
Bramley, Anna M. ; Reed, Carrie ; Finelli, Lyn ; Self, Wesley H. ; Ampofo, Krow ; Arnold, Sandra ; Williams, Derek J. ; Grijalva, Carlos G. ; Anderson, Evan J. ; Stockmann, Chris ; Trabue, Christopher ; Fakhran, Sherene ; Balk, Robert ; Mccullers, Jonathan ; Pavia, Andrew T. ; Edwards, Kathryn M. ; Wunderink, Richard G. ; Jain, Seema. / Relationship between Body Mass Index and Outcomes among Hospitalized Patients with Community-Acquired Pneumonia. In: Journal of Infectious Diseases. 2017 ; Vol. 215, No. 12. pp. 1873-1882.
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abstract = "Background. The effect of body mass index (BMI) on community-acquired pneumonia (CAP) severity is unclear. Methods. We investigated the relationship between BMI and CAP outcomes (hospital length of stay [LOS], intensive care unit [ICU] admission, and invasive mechanical ventilation) in hospitalized CAP patients from the Centers for Disease Control and Prevention Etiology of Pneumonia in the Community (EPIC) study, adjusting for age, demographics, underlying conditions, and smoking status (adults only). Results. Compared with normal-weight children, odds of ICU admission were higher in children who were overweight (adjusted odds ratio [aOR], 1.7; 95{\%} confidence interval [CI], 1.1-2.8) or obese (aOR, 2.1; 95{\%} CI, 1.4-3.2), and odds of mechanical ventilation were higher in children with obesity (aOR, 2.7; 95{\%} CI, 1.3-5.6). When stratified by asthma (presence/absence), these findings remained significant only in children with asthma. Compared with normal-weight adults, odds of LOS >3 days were higher in adults who were underweight (aOR, 1.6; 95{\%} CI, 1.1-2.4), and odds of mechanical ventilation were lowest in adults who were overweight (aOR, 0.5; 95{\%} CI,.3-.9). Conclusions. Children who were overweight or obese, particularly those with asthma, had higher odds of ICU admission or mechanical ventilation. In contrast, adults who were underweight had longer LOS. These results underscore the complex relationship between BMI and CAP outcomes.",
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AU - Bramley, Anna M.

AU - Reed, Carrie

AU - Finelli, Lyn

AU - Self, Wesley H.

AU - Ampofo, Krow

AU - Arnold, Sandra

AU - Williams, Derek J.

AU - Grijalva, Carlos G.

AU - Anderson, Evan J.

AU - Stockmann, Chris

AU - Trabue, Christopher

AU - Fakhran, Sherene

AU - Balk, Robert

AU - Mccullers, Jonathan

AU - Pavia, Andrew T.

AU - Edwards, Kathryn M.

AU - Wunderink, Richard G.

AU - Jain, Seema

PY - 2017/6/15

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N2 - Background. The effect of body mass index (BMI) on community-acquired pneumonia (CAP) severity is unclear. Methods. We investigated the relationship between BMI and CAP outcomes (hospital length of stay [LOS], intensive care unit [ICU] admission, and invasive mechanical ventilation) in hospitalized CAP patients from the Centers for Disease Control and Prevention Etiology of Pneumonia in the Community (EPIC) study, adjusting for age, demographics, underlying conditions, and smoking status (adults only). Results. Compared with normal-weight children, odds of ICU admission were higher in children who were overweight (adjusted odds ratio [aOR], 1.7; 95% confidence interval [CI], 1.1-2.8) or obese (aOR, 2.1; 95% CI, 1.4-3.2), and odds of mechanical ventilation were higher in children with obesity (aOR, 2.7; 95% CI, 1.3-5.6). When stratified by asthma (presence/absence), these findings remained significant only in children with asthma. Compared with normal-weight adults, odds of LOS >3 days were higher in adults who were underweight (aOR, 1.6; 95% CI, 1.1-2.4), and odds of mechanical ventilation were lowest in adults who were overweight (aOR, 0.5; 95% CI,.3-.9). Conclusions. Children who were overweight or obese, particularly those with asthma, had higher odds of ICU admission or mechanical ventilation. In contrast, adults who were underweight had longer LOS. These results underscore the complex relationship between BMI and CAP outcomes.

AB - Background. The effect of body mass index (BMI) on community-acquired pneumonia (CAP) severity is unclear. Methods. We investigated the relationship between BMI and CAP outcomes (hospital length of stay [LOS], intensive care unit [ICU] admission, and invasive mechanical ventilation) in hospitalized CAP patients from the Centers for Disease Control and Prevention Etiology of Pneumonia in the Community (EPIC) study, adjusting for age, demographics, underlying conditions, and smoking status (adults only). Results. Compared with normal-weight children, odds of ICU admission were higher in children who were overweight (adjusted odds ratio [aOR], 1.7; 95% confidence interval [CI], 1.1-2.8) or obese (aOR, 2.1; 95% CI, 1.4-3.2), and odds of mechanical ventilation were higher in children with obesity (aOR, 2.7; 95% CI, 1.3-5.6). When stratified by asthma (presence/absence), these findings remained significant only in children with asthma. Compared with normal-weight adults, odds of LOS >3 days were higher in adults who were underweight (aOR, 1.6; 95% CI, 1.1-2.4), and odds of mechanical ventilation were lowest in adults who were overweight (aOR, 0.5; 95% CI,.3-.9). Conclusions. Children who were overweight or obese, particularly those with asthma, had higher odds of ICU admission or mechanical ventilation. In contrast, adults who were underweight had longer LOS. These results underscore the complex relationship between BMI and CAP outcomes.

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DO - 10.1093/infdis/jix241

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