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Influence of Obesity Diagnosis With Organ Dysfunction, Mortality, and Resource Use Among Children Hospitalized With Infection in the United States.
J Intensive Care Med. 2017 Jun; 32(5):339-345.JI

Abstract

BACKGROUND

Sepsis induces inflammation in response to infection and is a major cause of mortality and hospitalization in children. Obesity induces chronic inflammation leading to many clinical manifestations. Our understanding of the impact of obesity on diseases, such as infection and sepsis, is limited. The objective of this study was to evaluate the association of obesity with organ dysfunction, mortality, duration, and charges during among US children hospitalized with infection.

METHODS

Retrospective study of hospitalizations in children with infection aged 0 to 20 years, using the 2009 Kids' Inpatient Database.

RESULTS

Of 3.4 million hospitalizations, 357 701 were for infection, 5685 of which were reported as obese children. Obese patients had higher rates of organ dysfunction (7.35% vs 5.5%, P < .01), longer hospital stays (4.1 vs 3.5 days, P < .001), and accrued higher charges (US$29 019 vs US$21 200, P < .001). In multivariable analysis, mortality did not differ by obesity status (odds ratio: 0.56, 95% confidence interval: 0.23-1.34), however severity of illness modified the association between obesity status and the other outcomes.

CONCLUSIONS

While there was no difference in in-hospital mortality by obesity diagnosis, variation in organ dysfunction, hospital stay, and hospital charges according to obesity status was mediated by illness severity. Findings from this study have significant implications for targeted approaches to mitigate the burden of obesity on infection and sepsis.

Authors+Show Affiliations

1 Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, MI, USA.1 Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, MI, USA.1 Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, MI, USA.1 Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, MI, USA.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

26880005

Citation

Maley, Nidhi, et al. "Influence of Obesity Diagnosis With Organ Dysfunction, Mortality, and Resource Use Among Children Hospitalized With Infection in the United States." Journal of Intensive Care Medicine, vol. 32, no. 5, 2017, pp. 339-345.
Maley N, Gebremariam A, Odetola F, et al. Influence of Obesity Diagnosis With Organ Dysfunction, Mortality, and Resource Use Among Children Hospitalized With Infection in the United States. J Intensive Care Med. 2017;32(5):339-345.
Maley, N., Gebremariam, A., Odetola, F., & Singer, K. (2017). Influence of Obesity Diagnosis With Organ Dysfunction, Mortality, and Resource Use Among Children Hospitalized With Infection in the United States. Journal of Intensive Care Medicine, 32(5), 339-345. https://doi.org/10.1177/0885066616631325
Maley N, et al. Influence of Obesity Diagnosis With Organ Dysfunction, Mortality, and Resource Use Among Children Hospitalized With Infection in the United States. J Intensive Care Med. 2017;32(5):339-345. PubMed PMID: 26880005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of Obesity Diagnosis With Organ Dysfunction, Mortality, and Resource Use Among Children Hospitalized With Infection in the United States. AU - Maley,Nidhi, AU - Gebremariam,Achamyeleh, AU - Odetola,Folafoluwa, AU - Singer,Kanakadurga, Y1 - 2016/02/14/ PY - 2016/2/18/pubmed PY - 2018/3/20/medline PY - 2016/2/17/entrez KW - and illness severity KW - child KW - hospitalization KW - infection KW - length of stay KW - obesity SP - 339 EP - 345 JF - Journal of intensive care medicine JO - J Intensive Care Med VL - 32 IS - 5 N2 - BACKGROUND: Sepsis induces inflammation in response to infection and is a major cause of mortality and hospitalization in children. Obesity induces chronic inflammation leading to many clinical manifestations. Our understanding of the impact of obesity on diseases, such as infection and sepsis, is limited. The objective of this study was to evaluate the association of obesity with organ dysfunction, mortality, duration, and charges during among US children hospitalized with infection. METHODS: Retrospective study of hospitalizations in children with infection aged 0 to 20 years, using the 2009 Kids' Inpatient Database. RESULTS: Of 3.4 million hospitalizations, 357 701 were for infection, 5685 of which were reported as obese children. Obese patients had higher rates of organ dysfunction (7.35% vs 5.5%, P < .01), longer hospital stays (4.1 vs 3.5 days, P < .001), and accrued higher charges (US$29 019 vs US$21 200, P < .001). In multivariable analysis, mortality did not differ by obesity status (odds ratio: 0.56, 95% confidence interval: 0.23-1.34), however severity of illness modified the association between obesity status and the other outcomes. CONCLUSIONS: While there was no difference in in-hospital mortality by obesity diagnosis, variation in organ dysfunction, hospital stay, and hospital charges according to obesity status was mediated by illness severity. Findings from this study have significant implications for targeted approaches to mitigate the burden of obesity on infection and sepsis. SN - 1525-1489 UR - https://www.unboundmedicine.com/medline/citation/26880005/Influence_of_Obesity_Diagnosis_With_Organ_Dysfunction_Mortality_and_Resource_Use_Among_Children_Hospitalized_With_Infection_in_the_United_States_ L2 - https://journals.sagepub.com/doi/10.1177/0885066616631325?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -