Obesity and Mortality, Length of Stay and Hospital Cost among Patients with Sepsis: A Nationwide Inpatient Retrospective Cohort Study

被引：53

作者：

Anh Tuan Nguyen ^{[1
]}

Tsai, Chu-lin ^{[2
]}

Hwang, Lu-yu ^{[3
]}

Lai, Dejian ^{[4
]}

Markham, Christine ^{[5
]}

Patel, Bela ^{[6
]}

机构：

[1] Vinmec Int Hosp, Dept Gen Planning, Hanoi, Vietnam

[2] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Emergency Med, Boston, MA USA

[3] Univ Texas Hlth Sci Ctr Houston, Dept Epidemiol Human Genet & Environm Sci, Sch Publ Hlth, Houston, TX 77030 USA

[4] Univ Texas Hlth Sci Ctr Houston, Sch Publ Hlth, Dept Biostat, Houston, TX 77030 USA

[5] Univ Texas Hlth Sci Ctr Houston, Sch Publ Hlth, Dept Hlth Promot & Behav Sci, Houston, TX 77030 USA

[6] Univ Texas Hlth Sci Ctr Houston, Sch Med, Div Crit Care Med, Houston, TX 77030 USA

来源：

PLOS ONE | 2016年 / 11卷 / 04期

关键词：

BODY-MASS INDEX; INTENSIVE-CARE-UNIT; LOGISTIC-REGRESSION; POOLED ANALYSIS; SEPTIC SHOCK; ALL-CAUSE; PARADOX; ASSOCIATION; OUTCOMES; DISEASE;

D O I：

10.1371/journal.pone.0154599

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Objectives The objective of this study was to examine the association between obesity and all-cause mortality, length of stay and hospital cost among patients with sepsis 20 years of age or older. Materials and Methods It was a retrospective cohort study. The dataset was the Nationwide Inpatient Sample 2011, the largest publicly available all-payer inpatient care database in the United States. Hospitalizations of sepsis patients 20 years of age or older were included. All 25 primary and secondary diagnosis fields were screened to identify patients with sepsis using International Classification of Diseases, Ninth Revision, Clinical Modification codes. Obesity was the exposure of interest. It was one of the 29 standardized Elixhauser comorbidity measures and readily available in the dataset as a dichotomized variable. The outcome measures were all-cause in-hospital death, length of stay and hospital cost. Results After weighting, our sample projected to a population size of 1,763,000, providing an approximation for the number of hospital discharges of all sepsis patients 20 years of age or older in the US in 2011. The overall all-cause mortality rate was 14.8%, the median hospital length of stay was 7 days and the median hospital cost was $15,917. After adjustment, the all-cause mortality was lower (adjusted OR = 0.84; 95% CI = 0.81 to 0.88); the average hospital length of stay was longer (adjusted difference = 0.65 day; 95% CI = 0.44 to 0.86) and the hospital cost per stay was higher (adjusted difference = $2,927; 95% CI = $1,606 to $4,247) for obese sepsis patients as compared to non-obese ones. Conclusion With this large and nationally representative sample of over 1,000 hospitals in the US, we found that obesity was significantly associated with a 16% decrease in the odds of dying among hospitalized sepsis patients; however it was also associated with greater duration and cost of hospitalization.

引用

页数：12

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