Obesity as a mortality risk factor in the medical ward: a case control study

BMC Endocrine Disorders

David L. Reich¹  Benjamin S. Glicksberg²  Eyal Zimlichman³  Robert Freeman⁴  Matthew A. Levin⁵  Shelly Soffer⁶  Eyal Klang⁷  Orly Efros⁸ 

[1] Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, USA;Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA;Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA;Hospital Management, Sheba Medical Center, Tel Hashomer, Israel;Sackler Medical School, Tel Aviv University, Tel Aviv, Israel;Sheba Talpiot Medical Leadership Program, Tel Hashomer, Israel;Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA;Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA;Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, USA;Internal Medicine B, Assuta Medical Center, Ashdod, Israel;Ben-Gurion University of the Negev, Be’er Sheva, Israel;Sackler Medical School, Tel Aviv University, Tel Aviv, Israel;Sheba Talpiot Medical Leadership Program, Tel Hashomer, Israel;Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel;Thrombosis & Hemostasis Unit, Sheba Medical Center, Tel Hashomer, Israel;Sackler Medical School, Tel Aviv University, Tel Aviv, Israel;

关键词: Obesity;    Hospital mortality;    COVID-19;    SARS-CoV-2;   

DOI  :  10.1186/s12902-021-00912-5

来源: Springer

【 摘 要 】

BackgroundResearch regarding the association between severe obesity and in-hospital mortality is inconsistent. We evaluated the impact of body mass index (BMI) levels on mortality in the medical wards. The analysis was performed separately before and during the COVID-19 pandemic.MethodsWe retrospectively retrieved data of adult patients admitted to the medical wards at the Mount Sinai Health System in New York City. The study was conducted between January 1, 2011, to March 23, 2021. Patients were divided into two sub-cohorts: pre-COVID-19 and during-COVID-19. Patients were then clustered into groups based on BMI ranges. A multivariate logistic regression analysis compared the mortality rate among the BMI groups, before and during the pandemic.ResultsOverall, 179,288 patients were admitted to the medical wards and had a recorded BMI measurement. 149,098 were admitted before the COVID-19 pandemic and 30,190 during the pandemic. Pre-pandemic, multivariate analysis showed a “J curve” between BMI and mortality. Severe obesity (BMI > 40) had an aOR of 0.8 (95% CI:0.7–1.0, p = 0.018) compared to the normal BMI group. In contrast, during the pandemic, the analysis showed a “U curve” between BMI and mortality. Severe obesity had an aOR of 1.7 (95% CI:1.3–2.4, p < 0.001) compared to the normal BMI group.ConclusionsMedical ward patients with severe obesity have a lower risk for mortality compared to patients with normal BMI. However, this does not apply during COVID-19, where obesity was a leading risk factor for mortality in the medical wards. It is important for the internal medicine physician to understand the intricacies of the association between obesity and medical ward mortality.

【 授权许可】

CC BY