Cargando…
Overweight or obese BMI is associated with earlier, but not later survival after common acute illnesses
BACKGROUND: Obesity has been associated with improved short-term mortality following common acute illness, but its relationship with longer-term mortality is unknown. METHODS: Observational study of U.S. Health and Retirement Study (HRS) participants with federal health insurance (fee-for-service Me...
Autores principales: | , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801673/ https://www.ncbi.nlm.nih.gov/pubmed/29409463 http://dx.doi.org/10.1186/s12877-018-0726-2 |
_version_ | 1783298392097554432 |
---|---|
author | Prescott, Hallie C. Chang, Virginia W. |
author_facet | Prescott, Hallie C. Chang, Virginia W. |
author_sort | Prescott, Hallie C. |
collection | PubMed |
description | BACKGROUND: Obesity has been associated with improved short-term mortality following common acute illness, but its relationship with longer-term mortality is unknown. METHODS: Observational study of U.S. Health and Retirement Study (HRS) participants with federal health insurance (fee-for-service Medicare) coverage, hospitalized with congestive heart failure (N = 4287), pneumonia (N = 4182), or acute myocardial infarction (N = 2001), 1996–2012. Using cox proportional hazards models, we examined the association between overweight or obese BMI (BMI ≥ 25.0 kg/m(2)) and mortality to 5 years after hospital admission, adjusted for potential confounders measured at the same time as BMI, including age, race, sex, education, partnership status, income, wealth, and smoking status. Body mass index (BMI) was calculated from self-reported height and weight collected at the HRS survey prior to hospitalization (a median 1.1 year prior to hospitalization). The referent group was patients with a normal BMI (18.5 to < 25.0 kg/m(2)). RESULTS: Patients were a median of 79 years old (IQR 71–85 years). The majority of patients were overweight or obese: 60.3% hospitalized for heart failure, 51.5% for pneumonia, and 61.6% for acute myocardial infarction. Overweight or obese BMI was associated with lower mortality at 1 year after hospitalization for congestive heart failure, pneumonia, and acute myocardial infarction—with adjusted hazard ratios of 0.68 (95% CI 0.59–0.79), 0.74 (95% CI: 0.64–0.84), and 0.65 (95%CI: 0.53–0.80), respectively. Among participants who lived to one year, however, subsequent survival was similar between patients with normal versus overweight/obese BMI. CONCLUSIONS: In older Americans, overweight or obese BMI was associated with improved survival following hospitalization for congestive heart failure, pneumonia, and acute myocardial infarction. This association, however, is limited to the shorter-term. Conditional on surviving to one year, we did not observe a survival advantage associated with excess weight. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-018-0726-2) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5801673 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-58016732018-02-14 Overweight or obese BMI is associated with earlier, but not later survival after common acute illnesses Prescott, Hallie C. Chang, Virginia W. BMC Geriatr Research Article BACKGROUND: Obesity has been associated with improved short-term mortality following common acute illness, but its relationship with longer-term mortality is unknown. METHODS: Observational study of U.S. Health and Retirement Study (HRS) participants with federal health insurance (fee-for-service Medicare) coverage, hospitalized with congestive heart failure (N = 4287), pneumonia (N = 4182), or acute myocardial infarction (N = 2001), 1996–2012. Using cox proportional hazards models, we examined the association between overweight or obese BMI (BMI ≥ 25.0 kg/m(2)) and mortality to 5 years after hospital admission, adjusted for potential confounders measured at the same time as BMI, including age, race, sex, education, partnership status, income, wealth, and smoking status. Body mass index (BMI) was calculated from self-reported height and weight collected at the HRS survey prior to hospitalization (a median 1.1 year prior to hospitalization). The referent group was patients with a normal BMI (18.5 to < 25.0 kg/m(2)). RESULTS: Patients were a median of 79 years old (IQR 71–85 years). The majority of patients were overweight or obese: 60.3% hospitalized for heart failure, 51.5% for pneumonia, and 61.6% for acute myocardial infarction. Overweight or obese BMI was associated with lower mortality at 1 year after hospitalization for congestive heart failure, pneumonia, and acute myocardial infarction—with adjusted hazard ratios of 0.68 (95% CI 0.59–0.79), 0.74 (95% CI: 0.64–0.84), and 0.65 (95%CI: 0.53–0.80), respectively. Among participants who lived to one year, however, subsequent survival was similar between patients with normal versus overweight/obese BMI. CONCLUSIONS: In older Americans, overweight or obese BMI was associated with improved survival following hospitalization for congestive heart failure, pneumonia, and acute myocardial infarction. This association, however, is limited to the shorter-term. Conditional on surviving to one year, we did not observe a survival advantage associated with excess weight. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-018-0726-2) contains supplementary material, which is available to authorized users. BioMed Central 2018-02-06 /pmc/articles/PMC5801673/ /pubmed/29409463 http://dx.doi.org/10.1186/s12877-018-0726-2 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Prescott, Hallie C. Chang, Virginia W. Overweight or obese BMI is associated with earlier, but not later survival after common acute illnesses |
title | Overweight or obese BMI is associated with earlier, but not later survival after common acute illnesses |
title_full | Overweight or obese BMI is associated with earlier, but not later survival after common acute illnesses |
title_fullStr | Overweight or obese BMI is associated with earlier, but not later survival after common acute illnesses |
title_full_unstemmed | Overweight or obese BMI is associated with earlier, but not later survival after common acute illnesses |
title_short | Overweight or obese BMI is associated with earlier, but not later survival after common acute illnesses |
title_sort | overweight or obese bmi is associated with earlier, but not later survival after common acute illnesses |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801673/ https://www.ncbi.nlm.nih.gov/pubmed/29409463 http://dx.doi.org/10.1186/s12877-018-0726-2 |
work_keys_str_mv | AT prescotthalliec overweightorobesebmiisassociatedwithearlierbutnotlatersurvivalaftercommonacuteillnesses AT changvirginiaw overweightorobesebmiisassociatedwithearlierbutnotlatersurvivalaftercommonacuteillnesses |