TY - JOUR
T1 - Overweight or obese BMI is associated with earlier, but not later survival after common acute illnesses
AU - Prescott, Hallie C.
AU - Chang, Virginia W,
N1 - Funding Information:
This work was supported by grants K08 GM115859 from the National Institutes of Health [HCP] and 7–12-CT-12 from the American Diabetes Association [VWC]. The Health and Retirement Study is sponsored by the National Institute on Aging (U01 AG009740) and performed at the Institute for Social Research, University of Michigan. The funders were not involved in the design, conduct, or reporting of the study.
Publisher Copyright:
© 2018 The Author(s).
PY - 2018/2/6
Y1 - 2018/2/6
N2 - 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/m2) 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/m2). 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.
AB - 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/m2) 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/m2). 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.
KW - Medicare
KW - acute myocardial infarction
KW - congestive heart failure
KW - hospitalization
KW - obesity
KW - pneumonia
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U2 - 10.1186/s12877-018-0726-2
DO - 10.1186/s12877-018-0726-2
M3 - Article
C2 - 29409463
AN - SCOPUS:85041503618
SN - 1471-2318
VL - 18
JO - BMC Geriatrics
JF - BMC Geriatrics
IS - 1
M1 - 42
ER -