Anna M Bramley1, Carrie Reed1, Lyn Finelli1, Wesley H Self2, Krow Ampofo3, Sandra R Arnold4,5, Derek J Williams2,6, Carlos G Grijalva2, Evan J Anderson7, Chris Stockmann3, Christopher Trabue8, Sherene Fakhran9, Robert Balk10, Jonathan A McCullers4,5,11, Andrew T Pavia3, Kathryn M Edwards2,6, Richard G Wunderink12, Seema Jain1. 1. Centers for Disease Control and Prevention, Atlanta, Georgia. 2. Vanderbilt University School of Medicine, Nashville, Tennessee. 3. University of Utah Health Sciences Center, Salt Lake City. 4. Le Bonheur Children's Hospital, Memphis. 5. University of Tennessee Health Science Center, Memphis. 6. Vanderbilt Vaccine Research Program, Nashville, Tennessee. 7. Emory University School of Medicine, Atlanta, Georgia. 8. University of Tennessee Health Science Center/Saint Thomas Health, Nashville. 9. John H. Stroger, Jr Hospital of Cook County. 10. Rush University Medical Center, Chicago, Illinois. 11. St Jude Children's Research Hospital, Memphis, Tennessee. 12. Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.
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. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.
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