The Association Between BMI and Mortality in Surgical Patients
Background While obesity is commonly associated with increased morbidity and mortality, in patients with chronic diseases, it has have been associated with a better prognosis, a phenomenon known as the 'obesity paradox'. Objective We investigated the relationship between mortality, length...
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| Veröffentlicht in: | World journal of surgery 2021-05, Vol.45 (5), p.1390-1399 |
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| container_title | World journal of surgery |
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| creator | Dotan, Idit Shochat, Tzipora Shimon, Ilan Akirov, Amit |
| description | Background
While obesity is commonly associated with increased morbidity and mortality, in patients with chronic diseases, it has have been associated with a better prognosis, a phenomenon known as the 'obesity paradox'.
Objective
We investigated the relationship between mortality, length of hospital stay (LOHS), and body mass index (BMI) in patients hospitalized to general surgical wards.
Methods
We extracted data of patients admitted to the hospital between January 2011 and December 2017. BMI was classified according to the following categories: underweight ( |
| doi_str_mv | 10.1007/s00268-021-05961-4 |
| format | Article |
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While obesity is commonly associated with increased morbidity and mortality, in patients with chronic diseases, it has have been associated with a better prognosis, a phenomenon known as the 'obesity paradox'.
Objective
We investigated the relationship between mortality, length of hospital stay (LOHS), and body mass index (BMI) in patients hospitalized to general surgical wards.
Methods
We extracted data of patients admitted to the hospital between January 2011 and December 2017. BMI was classified according to the following categories: underweight (< 18.5), normal weight (18.5–24.9), overweight (25–29.9), obesity (30–34.9) and severe obesity (≥ 35). Main outcomes were mortality at 30-day mortality and at the end-of-follow-up mortality), as well as LOHS.
Results
A total of 27,639 patients (mean age 55 ± 20 years; 48% males; 19% had diabetes) were included in the study. Median LOHS was longer in patients with diabetes vs. those without diabetes (4.0 vs 3.0 days, respectively), with longest LOHS among underweight patients. A 30-day mortality was 2% of those without (371/22,297) and 3% of those with diabetes (173/5,342). In patients with diabetes, 30-day mortality risk showed a step-wise decrease with increased BMI: 10% for underweight, 6% for normal weight, 3% for overweight, 2% for obese and only 1% for severely obese patients. In patients without diabetes, 30-day mortality was found to be 6% for underweight, 3% for normal weight and 1% across the overweight and obese categories. Mortality rate at the end-of-follow-up was 9% of patients without diabetes and 18% of those with diabetes (adjusted OR = 1.3, 95% CI, 1.2–1.5). In patients with diabetes, mortality risk showed an inverse association with respect to BMI: 52% for underweight, 29% for normal weight, 17% for overweight, 14% for obesity and 7% for severely obese patients, with similar trend in patients without diabetes.
Conclusions
The results support the ‘obesity paradox’ in the general surgical patients as those with and without diabetes admitted to surgical wards, BMI had an inverse association with short- and long-term mortality.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-021-05961-4</identifier><identifier>PMID: 33481082</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Body mass ; Body mass index ; Body size ; Body weight ; Cardiac Surgery ; Chronic illnesses ; Diabetes ; Diabetes mellitus ; General Surgery ; Health risks ; Medicine ; Medicine & Public Health ; Morbidity ; Mortality ; Obesity ; Original Scientific Report ; Overweight ; Paradoxes ; Surgery ; Thoracic Surgery ; Underweight ; Vascular Surgery</subject><ispartof>World journal of surgery, 2021-05, Vol.45 (5), p.1390-1399</ispartof><rights>Société Internationale de Chirurgie 2021</rights><rights>2021 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>Société Internationale de Chirurgie 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4266-c68e809f627d8880f7bcbe1ab777ba310d87bbd0df7d84fb04f96aee00cf42d3</citedby><cites>FETCH-LOGICAL-c4266-c68e809f627d8880f7bcbe1ab777ba310d87bbd0df7d84fb04f96aee00cf42d3</cites><orcidid>0000-0002-9376-344X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-021-05961-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-021-05961-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,1416,27922,27923,41486,42555,45572,45573,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33481082$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dotan, Idit</creatorcontrib><creatorcontrib>Shochat, Tzipora</creatorcontrib><creatorcontrib>Shimon, Ilan</creatorcontrib><creatorcontrib>Akirov, Amit</creatorcontrib><title>The Association Between BMI and Mortality in Surgical Patients</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
While obesity is commonly associated with increased morbidity and mortality, in patients with chronic diseases, it has have been associated with a better prognosis, a phenomenon known as the 'obesity paradox'.
Objective
We investigated the relationship between mortality, length of hospital stay (LOHS), and body mass index (BMI) in patients hospitalized to general surgical wards.
Methods
We extracted data of patients admitted to the hospital between January 2011 and December 2017. BMI was classified according to the following categories: underweight (< 18.5), normal weight (18.5–24.9), overweight (25–29.9), obesity (30–34.9) and severe obesity (≥ 35). Main outcomes were mortality at 30-day mortality and at the end-of-follow-up mortality), as well as LOHS.
Results
A total of 27,639 patients (mean age 55 ± 20 years; 48% males; 19% had diabetes) were included in the study. Median LOHS was longer in patients with diabetes vs. those without diabetes (4.0 vs 3.0 days, respectively), with longest LOHS among underweight patients. A 30-day mortality was 2% of those without (371/22,297) and 3% of those with diabetes (173/5,342). In patients with diabetes, 30-day mortality risk showed a step-wise decrease with increased BMI: 10% for underweight, 6% for normal weight, 3% for overweight, 2% for obese and only 1% for severely obese patients. In patients without diabetes, 30-day mortality was found to be 6% for underweight, 3% for normal weight and 1% across the overweight and obese categories. Mortality rate at the end-of-follow-up was 9% of patients without diabetes and 18% of those with diabetes (adjusted OR = 1.3, 95% CI, 1.2–1.5). In patients with diabetes, mortality risk showed an inverse association with respect to BMI: 52% for underweight, 29% for normal weight, 17% for overweight, 14% for obesity and 7% for severely obese patients, with similar trend in patients without diabetes.
Conclusions
The results support the ‘obesity paradox’ in the general surgical patients as those with and without diabetes admitted to surgical wards, BMI had an inverse association with short- and long-term mortality.</description><subject>Abdominal Surgery</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Body weight</subject><subject>Cardiac Surgery</subject><subject>Chronic illnesses</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>General Surgery</subject><subject>Health risks</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Obesity</subject><subject>Original Scientific Report</subject><subject>Overweight</subject><subject>Paradoxes</subject><subject>Surgery</subject><subject>Thoracic Surgery</subject><subject>Underweight</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkEtLxDAUhYMozjj6B1xIwY2b6s1jktSFoOL4YERhBlyGtL0dK51WkxaZf2-0PsCFuLqBfOdw-AjZpXBIAdSRB2BSx8BoDONE0liskSEVnMWMM75OhsClCG_KB2TL-ycAqiTITTLgXGgKmg3JyfwRo1Pvm6y0bdnU0Rm2r4jh3l5Hts6j28a1tirbVVTW0axzizKzVXQfYKxbv002Clt53Pm8IzKfXMzPr-Lp3eX1-ek0zgSTMs6kRg1JIZnKtdZQqDRLkdpUKZVaTiHXKk1zyIvwL4oURJFIiwiQFYLlfEQO-tpn17x06FuzLH2GVWVrbDpvmNDAEp1QHdD9X-hT07k6jDNsDIlgmo7HgWI9lbnGe4eFeXbl0rqVoWDe5ZperglyzYdcI0Jo77O6S5eYf0e-bAbguAdeywpX_6g0DzezswlAomQI8z7sQ65eoPsZ_semN9YklDw</recordid><startdate>202105</startdate><enddate>202105</enddate><creator>Dotan, Idit</creator><creator>Shochat, Tzipora</creator><creator>Shimon, Ilan</creator><creator>Akirov, Amit</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9376-344X</orcidid></search><sort><creationdate>202105</creationdate><title>The Association Between BMI and Mortality in Surgical Patients</title><author>Dotan, Idit ; Shochat, Tzipora ; Shimon, Ilan ; Akirov, Amit</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4266-c68e809f627d8880f7bcbe1ab777ba310d87bbd0df7d84fb04f96aee00cf42d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Abdominal Surgery</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Body weight</topic><topic>Cardiac Surgery</topic><topic>Chronic illnesses</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>General Surgery</topic><topic>Health risks</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Obesity</topic><topic>Original Scientific Report</topic><topic>Overweight</topic><topic>Paradoxes</topic><topic>Surgery</topic><topic>Thoracic Surgery</topic><topic>Underweight</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dotan, Idit</creatorcontrib><creatorcontrib>Shochat, Tzipora</creatorcontrib><creatorcontrib>Shimon, Ilan</creatorcontrib><creatorcontrib>Akirov, Amit</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dotan, Idit</au><au>Shochat, Tzipora</au><au>Shimon, Ilan</au><au>Akirov, Amit</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Association Between BMI and Mortality in Surgical Patients</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2021-05</date><risdate>2021</risdate><volume>45</volume><issue>5</issue><spage>1390</spage><epage>1399</epage><pages>1390-1399</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
While obesity is commonly associated with increased morbidity and mortality, in patients with chronic diseases, it has have been associated with a better prognosis, a phenomenon known as the 'obesity paradox'.
Objective
We investigated the relationship between mortality, length of hospital stay (LOHS), and body mass index (BMI) in patients hospitalized to general surgical wards.
Methods
We extracted data of patients admitted to the hospital between January 2011 and December 2017. BMI was classified according to the following categories: underweight (< 18.5), normal weight (18.5–24.9), overweight (25–29.9), obesity (30–34.9) and severe obesity (≥ 35). Main outcomes were mortality at 30-day mortality and at the end-of-follow-up mortality), as well as LOHS.
Results
A total of 27,639 patients (mean age 55 ± 20 years; 48% males; 19% had diabetes) were included in the study. Median LOHS was longer in patients with diabetes vs. those without diabetes (4.0 vs 3.0 days, respectively), with longest LOHS among underweight patients. A 30-day mortality was 2% of those without (371/22,297) and 3% of those with diabetes (173/5,342). In patients with diabetes, 30-day mortality risk showed a step-wise decrease with increased BMI: 10% for underweight, 6% for normal weight, 3% for overweight, 2% for obese and only 1% for severely obese patients. In patients without diabetes, 30-day mortality was found to be 6% for underweight, 3% for normal weight and 1% across the overweight and obese categories. Mortality rate at the end-of-follow-up was 9% of patients without diabetes and 18% of those with diabetes (adjusted OR = 1.3, 95% CI, 1.2–1.5). In patients with diabetes, mortality risk showed an inverse association with respect to BMI: 52% for underweight, 29% for normal weight, 17% for overweight, 14% for obesity and 7% for severely obese patients, with similar trend in patients without diabetes.
Conclusions
The results support the ‘obesity paradox’ in the general surgical patients as those with and without diabetes admitted to surgical wards, BMI had an inverse association with short- and long-term mortality.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>33481082</pmid><doi>10.1007/s00268-021-05961-4</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-9376-344X</orcidid></addata></record> |
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| language | eng |
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| source | Wiley Online Library All Journals; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Body mass Body mass index Body size Body weight Cardiac Surgery Chronic illnesses Diabetes Diabetes mellitus General Surgery Health risks Medicine Medicine & Public Health Morbidity Mortality Obesity Original Scientific Report Overweight Paradoxes Surgery Thoracic Surgery Underweight Vascular Surgery |
| title | The Association Between BMI and Mortality in Surgical Patients |
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