Paradoxical association between body mass index and in-hospital mortality in elderly patients with chronic obstructive pulmonary disease in Japan

• DOI: 10.2147/copd.s75175
• Publication Date: 2014-12-09T20:55:26Z
• Authors: Yasuhiro Yamauchi; Wakae Hasegawa; Hideo Yasunaga; Mitsuhiro Sunohara; Taisuke Jo; Hiroki Matsui; Kiyohide Fushimi; Kazutaka Takami; Takahide Nagase
• Keywords: Male; Databases, Factual; Comorbidity; International Journal of Chronic Obstructive Pulmonary Disease; Body Mass Index; Diseases of the respiratory system; Pulmonary Disease, Chronic Obstructive; 03 medical and health sciences; 0302 clinical medicine; Japan; Odds Ratio; Humans; Hospital Mortality; Obesity; Original Research; Aged; Retrospective Studies; Aged, 80 and over; 2. Zero hunger; Chi-Square Distribution; RC705-779; Age Factors; Protective Factors; 3. Good health; Hospitalization; Logistic Models; Multivariate Analysis; Female

The prevalence and mortality of chronic obstructive pulmonary disease (COPD) in elderly patients are increasing worldwide. Low body mass index (BMI) is a well-known prognostic factor for COPD. However, the obesity paradox with COPD has not been well elucidated. We investigated association between BMI in-hospital patients.Using Diagnosis Procedure Combination database Japan, we retrospectively collected data (>65 years) who were hospitalized July 2010 March 2013. performed multivariable logistic regression analysis to compare all-cause <18.5 kg/m2 (underweight), 18.5-22.9 (low-normal weight), 23.0-24.9 (high-normal 25.0-29.9 (overweight), ≥30.0 (obesity) adjustment patient backgrounds.In all, 263,940 eligible identified. In-hospital was 14.3%, 7.3%, 4.9%, 4.3%, 4.4%, respectively, underweight, low-normal weight, high-normal overweight, obese patients. Underweight had significantly higher than weight (odds ratio [OR]: 1.55, 95% confidence interval [CI]: 1.48-1.63), whereas lower associated (OR: 0.76, CI: 0.70-0.82), overweight 0.73, 0.66-0.80), 0.67, 0.52-0.86). Higher older age, male sex, more severe dyspnea, level consciousness, activities daily living.Overweight patients, which supports paradox.