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Chen Wei Frank Qian Ye Liu Luigi Maione Huei-Ching Hsu Wan-Ting Hsu Chien-Chang Lee 《Obesity research & clinical practice》2021,15(3):235-242
ObjectivesPrevious 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.DesignRetrospective cohort study.Setting and participantsData were collected from the US Nationwide Readmission Database from 2013 to 2014.MethodsPatients 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.Results132,965 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 implicationsObesity 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. 相似文献
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《Obesity research & clinical practice》2022,16(1):56-62
BackgroundPressure ulcers (PUs) are one of the leading potentially preventable adverse events in the hospital. Critically ill patients are at risk for the development of PUs. The primary aim of the study was to investigate the relation of PUs and obesity in critically ill ICU patients.MethodsA single center prospective cohort study was conducted on adult patients with obesity (defined as a body mass index BMI ≥ 30 kg/m2) and patients without obesity (BMI 18?25 kg/m2) admitted to the intensive care unit between May 2013 and July 2017 with an ICU length of stay of at least 3 days without pre-existing PUs at admission.Results851 of 1205 patients (70.6%) had a normal BMI and 354 (29.4%) had a BMI ≥ 30 kg/m2 and were considered obese. Overall, 157 patients (13.0%) developed PUs; 112/851 (13.2%) of patients without obesity and 45/354 (12.7%) of patients with obesity (p = 0.907). There was no difference in the severity (p = 0.609) and PU location (p = 0.261). Mean days to PU development was 11.1; 11.7 days for patients without obesity and 9.5 days for patients with obesity (p = 0.270). Mean days to PU recovery was 13.2, which was 14.1 days for patients without obesity and 10.8 days for patients with obesity (p = 0.215). A multivariate logistic regression model showed no significant correlation between the occurrence of PUs in the ICU and obesity (OR 0.875 with 95% CI 0.528–1.448, p = 0.594). Subgroup analysis showed that patients with morbid obesity (BMI ≥ 40 kg/m2) developed PUs earlier during ICU admission when compared to patients without obesity (p = 0.004).ConclusionOur study demonstrates that obesity is not an independent risk factor for the development of PUs in the ICU. However, patients with morbid obesity might develop PUs earlier compared to patients without obesity. 相似文献
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Pigeyre M Dauchet L Simon C Bongard V Bingham A Arveiler D Ruidavets JB Wagner A Ferrières J Amouyel P Dallongeville J 《Preventive medicine》2011,52(5):305-309
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In the past decade, the obesity prevalence in France steadily increased. In the meantime the occupational and educational status of the population improved. This study examined the impact of these changes on obesity trends in France.Methods
In the MONICA-France surveys in 1986, 1996 and 2006, 5423 men and 5271 women (35-64 yr old) were randomly recruited from electoral rolls in three areas of France (northern, eastern and south-western). We used a logistic regression to assess the association between obesity and time and occupational/educational categories and their interactions and a counterfactual analysis to assess the contributions of occupational and educational changes to obesity trends.Results
Between 1986 and 2006, the prevalence of obesity rose from 15.0% to 18.4% (p < 0.004) in men and remained stable between 15.9% and 17.2% (p = 0.72) in women. Obesity increased in all occupational categories only in men (men: p = 0.0005; women: p < 0.22) and all educational categories in both genders (p < 0.0001). The estimated contributions of occupational (educational) changes to obesity trends were − 0.3% (− 2.8%) in men and − 1.9% (− 4.6%) in women.Conclusion
The improvement in the French population's occupational status and educational level between 1986 and 2006 tended to reduce the impact of secular trends on the obesity prevalence. 相似文献7.
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