• Eur. J. Intern. Med. · Apr 2022

    Obesity survival paradox in patients hospitalized with community-acquired pneumonia. Assessing sex-differences in a population-based cohort study.

    • Javier de Miguel-Diez, Rodrigo Jimenez-Garcia, Valentin Hernandez-Barrera, Jose M de Miguel-Yanes, David Carabantes-Alarcon, Jose J Zamorano-Leon, and Ana Lopez-de-Andres.
    • Respiratory Care Department. Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid. Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM). Madrid, Spain.
    • Eur. J. Intern. Med. 2022 Apr 1; 98: 98-104.

    AimTo 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.MethodsWe 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.ResultsWe 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.ConclusionsObese 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.Copyright © 2022 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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