"Obesity Paradox" Holds True for Patients with Hip Fracture

Background: Hip fractures are associated with high mortality and reduced quality of life. Studies have reported a high body mass index (BMI) as being positively associated with survival when linked to old age and some chronic diseases. This phenomenon is called the “obesity paradox.” The association...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Journal of bone and joint surgery. American volume 2019, Vol.101 (10), p.888
Hauptverfasser: Modig, Karin, Erdefelt, Annelie, Mellner, Carl, Cederholm, Tommy, Talbäck, Mats, Hedström, Margareta
Format: Artikel
Sprache:eng
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page
container_issue 10
container_start_page 888
container_title Journal of bone and joint surgery. American volume
container_volume 101
creator Modig, Karin
Erdefelt, Annelie
Mellner, Carl
Cederholm, Tommy
Talbäck, Mats
Hedström, Margareta
description Background: Hip fractures are associated with high mortality and reduced quality of life. Studies have reported a high body mass index (BMI) as being positively associated with survival when linked to old age and some chronic diseases. This phenomenon is called the “obesity paradox.” The association between BMI and survival after hip fracture has not been thoroughly studied in large samples, nor has to what extent the association is altered by comorbidities, sex, and age. The objective of this study was to investigate the association of BMI with survival after hip fracture and with the probability of returning to living at home after hip fracture. Methods: This cohort study was based on data from a prospectively maintained national registry of patients with hip fracture. A total of 17,756 patients ‡65 years of age who were treated for hip fracture during the period of 2013 to 2016, and followed until the end of 2017, were included. BMI was clinically assessed at hospital admission, comorbidity was measured with the American Society of Anesthesiologists (ASA) score, and the date of death was retrieved from a national database. Self-reported data on living arrangements were assessed on admission and 4 months after fracture. Multivariable regression models were used to estimate the associations. Results: Despite ASA scores being similar among all BMI groups, obese patients had the highest 1-year survival and patients with a BMI of <22 kg/m2 had the lowest. Adjustment for potential confounders strengthened the associations. For the chance of returning to living at home, no advantage was seen for obese patients, but patients with a BMI of <22 kg/m2 had clearly worse odds compared with patients who were of normal weight, overweight, or obese. Conclusions: The obesity paradox appears to be true for hip fracture patients aged 65 and older. Attention should be given to patients with malnutrition and underweight status rather than to those with overweight status or obesity when developing the orthogeriatric care.
doi_str_mv 10.2106/JBJS.18.01249
format Article
fullrecord <record><control><sourceid>swepub</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_479770</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>oai_swepub_ki_se_479770</sourcerecordid><originalsourceid>FETCH-LOGICAL-c205t-7d90ac517a6ab3f0219545864640894f7470ca6d2e59efc6c4cf5275b53870793</originalsourceid><addsrcrecordid>eNp9jM1PwjAchnvQRESP3hvum79u_YwnRHESEkxEr03XtVoFt7RbgP9eEjl7et48efMgdEMgLwjw28X94jUnMgdSUHWGRoSVLCOl5BfoMqUvAKAUxAjdTVa1S6E_4BcTTdPuJ7hqN03C6zg47Nt49H1wP33Cu9B_4ip0eB6N7YfortC5N5vkrk8co7f543pWZcvV0_NsusxsAazPRKPAWEaE4aYuPRREMcokp5yCVNQLKsAa3hSOKectt9R6VghWs1IKEKoco-yvm3auG2rdxbA18aBbE_RJfR-X01QoIeDf_0N4n-o2fuhhO2jClOSk_AU3h1o1</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>"Obesity Paradox" Holds True for Patients with Hip Fracture</title><source>Alma/SFX Local Collection</source><creator>Modig, Karin ; Erdefelt, Annelie ; Mellner, Carl ; Cederholm, Tommy ; Talbäck, Mats ; Hedström, Margareta</creator><creatorcontrib>Modig, Karin ; Erdefelt, Annelie ; Mellner, Carl ; Cederholm, Tommy ; Talbäck, Mats ; Hedström, Margareta</creatorcontrib><description>Background: Hip fractures are associated with high mortality and reduced quality of life. Studies have reported a high body mass index (BMI) as being positively associated with survival when linked to old age and some chronic diseases. This phenomenon is called the “obesity paradox.” The association between BMI and survival after hip fracture has not been thoroughly studied in large samples, nor has to what extent the association is altered by comorbidities, sex, and age. The objective of this study was to investigate the association of BMI with survival after hip fracture and with the probability of returning to living at home after hip fracture. Methods: This cohort study was based on data from a prospectively maintained national registry of patients with hip fracture. A total of 17,756 patients ‡65 years of age who were treated for hip fracture during the period of 2013 to 2016, and followed until the end of 2017, were included. BMI was clinically assessed at hospital admission, comorbidity was measured with the American Society of Anesthesiologists (ASA) score, and the date of death was retrieved from a national database. Self-reported data on living arrangements were assessed on admission and 4 months after fracture. Multivariable regression models were used to estimate the associations. Results: Despite ASA scores being similar among all BMI groups, obese patients had the highest 1-year survival and patients with a BMI of &amp;lt;22 kg/m2 had the lowest. Adjustment for potential confounders strengthened the associations. For the chance of returning to living at home, no advantage was seen for obese patients, but patients with a BMI of &amp;lt;22 kg/m2 had clearly worse odds compared with patients who were of normal weight, overweight, or obese. Conclusions: The obesity paradox appears to be true for hip fracture patients aged 65 and older. Attention should be given to patients with malnutrition and underweight status rather than to those with overweight status or obesity when developing the orthogeriatric care.</description><identifier>ISSN: 1535-1386</identifier><identifier>ISSN: 0021-9355</identifier><identifier>DOI: 10.2106/JBJS.18.01249</identifier><language>eng</language><ispartof>Journal of bone and joint surgery. American volume, 2019, Vol.101 (10), p.888</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c205t-7d90ac517a6ab3f0219545864640894f7470ca6d2e59efc6c4cf5275b53870793</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-159861$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:140943288$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Modig, Karin</creatorcontrib><creatorcontrib>Erdefelt, Annelie</creatorcontrib><creatorcontrib>Mellner, Carl</creatorcontrib><creatorcontrib>Cederholm, Tommy</creatorcontrib><creatorcontrib>Talbäck, Mats</creatorcontrib><creatorcontrib>Hedström, Margareta</creatorcontrib><title>"Obesity Paradox" Holds True for Patients with Hip Fracture</title><title>Journal of bone and joint surgery. American volume</title><description>Background: Hip fractures are associated with high mortality and reduced quality of life. Studies have reported a high body mass index (BMI) as being positively associated with survival when linked to old age and some chronic diseases. This phenomenon is called the “obesity paradox.” The association between BMI and survival after hip fracture has not been thoroughly studied in large samples, nor has to what extent the association is altered by comorbidities, sex, and age. The objective of this study was to investigate the association of BMI with survival after hip fracture and with the probability of returning to living at home after hip fracture. Methods: This cohort study was based on data from a prospectively maintained national registry of patients with hip fracture. A total of 17,756 patients ‡65 years of age who were treated for hip fracture during the period of 2013 to 2016, and followed until the end of 2017, were included. BMI was clinically assessed at hospital admission, comorbidity was measured with the American Society of Anesthesiologists (ASA) score, and the date of death was retrieved from a national database. Self-reported data on living arrangements were assessed on admission and 4 months after fracture. Multivariable regression models were used to estimate the associations. Results: Despite ASA scores being similar among all BMI groups, obese patients had the highest 1-year survival and patients with a BMI of &amp;lt;22 kg/m2 had the lowest. Adjustment for potential confounders strengthened the associations. For the chance of returning to living at home, no advantage was seen for obese patients, but patients with a BMI of &amp;lt;22 kg/m2 had clearly worse odds compared with patients who were of normal weight, overweight, or obese. Conclusions: The obesity paradox appears to be true for hip fracture patients aged 65 and older. Attention should be given to patients with malnutrition and underweight status rather than to those with overweight status or obesity when developing the orthogeriatric care.</description><issn>1535-1386</issn><issn>0021-9355</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9jM1PwjAchnvQRESP3hvum79u_YwnRHESEkxEr03XtVoFt7RbgP9eEjl7et48efMgdEMgLwjw28X94jUnMgdSUHWGRoSVLCOl5BfoMqUvAKAUxAjdTVa1S6E_4BcTTdPuJ7hqN03C6zg47Nt49H1wP33Cu9B_4ip0eB6N7YfortC5N5vkrk8co7f543pWZcvV0_NsusxsAazPRKPAWEaE4aYuPRREMcokp5yCVNQLKsAa3hSOKectt9R6VghWs1IKEKoco-yvm3auG2rdxbA18aBbE_RJfR-X01QoIeDf_0N4n-o2fuhhO2jClOSk_AU3h1o1</recordid><startdate>2019</startdate><enddate>2019</enddate><creator>Modig, Karin</creator><creator>Erdefelt, Annelie</creator><creator>Mellner, Carl</creator><creator>Cederholm, Tommy</creator><creator>Talbäck, Mats</creator><creator>Hedström, Margareta</creator><scope>ADTPV</scope><scope>AOWAS</scope><scope>D93</scope></search><sort><creationdate>2019</creationdate><title>"Obesity Paradox" Holds True for Patients with Hip Fracture</title><author>Modig, Karin ; Erdefelt, Annelie ; Mellner, Carl ; Cederholm, Tommy ; Talbäck, Mats ; Hedström, Margareta</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c205t-7d90ac517a6ab3f0219545864640894f7470ca6d2e59efc6c4cf5275b53870793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Modig, Karin</creatorcontrib><creatorcontrib>Erdefelt, Annelie</creatorcontrib><creatorcontrib>Mellner, Carl</creatorcontrib><creatorcontrib>Cederholm, Tommy</creatorcontrib><creatorcontrib>Talbäck, Mats</creatorcontrib><creatorcontrib>Hedström, Margareta</creatorcontrib><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Umeå universitet</collection><jtitle>Journal of bone and joint surgery. American volume</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Modig, Karin</au><au>Erdefelt, Annelie</au><au>Mellner, Carl</au><au>Cederholm, Tommy</au><au>Talbäck, Mats</au><au>Hedström, Margareta</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>"Obesity Paradox" Holds True for Patients with Hip Fracture</atitle><jtitle>Journal of bone and joint surgery. American volume</jtitle><date>2019</date><risdate>2019</risdate><volume>101</volume><issue>10</issue><spage>888</spage><pages>888-</pages><issn>1535-1386</issn><issn>0021-9355</issn><abstract>Background: Hip fractures are associated with high mortality and reduced quality of life. Studies have reported a high body mass index (BMI) as being positively associated with survival when linked to old age and some chronic diseases. This phenomenon is called the “obesity paradox.” The association between BMI and survival after hip fracture has not been thoroughly studied in large samples, nor has to what extent the association is altered by comorbidities, sex, and age. The objective of this study was to investigate the association of BMI with survival after hip fracture and with the probability of returning to living at home after hip fracture. Methods: This cohort study was based on data from a prospectively maintained national registry of patients with hip fracture. A total of 17,756 patients ‡65 years of age who were treated for hip fracture during the period of 2013 to 2016, and followed until the end of 2017, were included. BMI was clinically assessed at hospital admission, comorbidity was measured with the American Society of Anesthesiologists (ASA) score, and the date of death was retrieved from a national database. Self-reported data on living arrangements were assessed on admission and 4 months after fracture. Multivariable regression models were used to estimate the associations. Results: Despite ASA scores being similar among all BMI groups, obese patients had the highest 1-year survival and patients with a BMI of &amp;lt;22 kg/m2 had the lowest. Adjustment for potential confounders strengthened the associations. For the chance of returning to living at home, no advantage was seen for obese patients, but patients with a BMI of &amp;lt;22 kg/m2 had clearly worse odds compared with patients who were of normal weight, overweight, or obese. Conclusions: The obesity paradox appears to be true for hip fracture patients aged 65 and older. Attention should be given to patients with malnutrition and underweight status rather than to those with overweight status or obesity when developing the orthogeriatric care.</abstract><doi>10.2106/JBJS.18.01249</doi></addata></record>
fulltext fulltext
identifier ISSN: 1535-1386
ispartof Journal of bone and joint surgery. American volume, 2019, Vol.101 (10), p.888
issn 1535-1386
0021-9355
language eng
recordid cdi_swepub_primary_oai_swepub_ki_se_479770
source Alma/SFX Local Collection
title "Obesity Paradox" Holds True for Patients with Hip Fracture
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T00%3A53%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-swepub&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=%22Obesity%20Paradox%22%20Holds%20True%20for%20Patients%20with%20Hip%20Fracture&rft.jtitle=Journal%20of%20bone%20and%20joint%20surgery.%20American%20volume&rft.au=Modig,%20Karin&rft.date=2019&rft.volume=101&rft.issue=10&rft.spage=888&rft.pages=888-&rft.issn=1535-1386&rft_id=info:doi/10.2106/JBJS.18.01249&rft_dat=%3Cswepub%3Eoai_swepub_ki_se_479770%3C/swepub%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/&rfr_iscdi=true