HIGHLIGHTS
- •We assessed the effect of obesity status on hospital outcomes after CAP in Spain.
- •Obese and morbidly obese patients have a lower risk of IHM than non-obese patients.
- •The obesity survival paradox appears similarly in men and women with CAP.
- •Prospective studies with detailed clinical data are needed to confirm our results.
ABSTRACT
Aim
To assess the effect of obesity status (no obesity/obesity/ morbid obesity) on hospital
outcomes (length of hospital stay [LOHS] and in-hospital mortality [IHM]), among patients
hospitalized with community-acquired pneumonia (CAP) and according to sex.
Methods
We conducted a retrospective cohort study based on national hospital discharge data
of all subjects aged≥ 18 years hospitalized with CAP in Spain from 2016 to 2019.
Results
We identified 519,750 hospital discharges with CAP. The prevalence of obesity was
6.38% and 1.78%. for morbid obesity. The mean age was higher for patients without
obesity followed by those with obesity and morbid obesity (74.61, 72.5 and 70.2 years
respectively; p<0.001). The mean number of comorbidities was similar for patients with obesity and
morbid obesity (2.30 and 2.29) and significantly higher than for non-obese individuals
(2.10). The crude IHM was higher among the non-obese patients (12.71%) followed by
those with morbid obesity (8.56%) and obesity (7.72%), without finding differences
between men and women. Among men, after multivariable logistic regression analysis,
the probability of dying in the hospital was significantly lower for those with obesity
(Adjusted-OR 0.59;95%CI 0.55–0.63) and morbid obesity (Adjusted-OR 0.62;95%CI 0.54–0.71)
compared with non-obese. The protective effect of obesity (Adjusted-OR 0.71;95%CI
0.67–0.75) and morbid obesity (Adjusted OR 0.73;95%CI 0.66–0.8) was also observed
among women.
Conclusions
Obese and obesity morbid patients with CAP have a lower risk of IHM than non-obese
patients, without sex differences in this association. These data confirm the existence
of the obesity paradox in this patient population.
Keywords
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Article info
Publication history
Published online: January 20, 2022
Accepted:
January 17,
2022
Received in revised form:
December 23,
2021
Received:
November 25,
2021
Identification
Copyright
© 2022 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
