Bramley Anna M, Reed Carrie, Finelli Lyn, Self Wesley H, Ampofo Krow, Arnold Sandra R, Williams Derek J, Grijalva Carlos G, Anderson Evan J, Stockmann Chris, Trabue Christopher, Fakhran Sherene, Balk Robert, McCullers Jonathan A, Pavia Andrew T, Edwards Kathryn M, Wunderink Richard G, Jain Seema
Centers for Disease Control and Prevention, Atlanta, Georgia.
Vanderbilt University School of Medicine, Nashville, Tennessee.
J Infect Dis. 2017 Jun 15;215(12):1873-1882. doi: 10.1093/infdis/jix241.
The effect of body mass index (BMI) on community-acquired pneumonia (CAP) severity is unclear.
We investigated the relationship between BMI and CAP outcomes (hospital length of stay [LOS], intensive care unit [ICU] admission, and invasive mechanical ventilation) in hospitalized CAP patients from the Centers for Disease Control and Prevention Etiology of Pneumonia in the Community (EPIC) study, adjusting for age, demographics, underlying conditions, and smoking status (adults only).
Compared with normal-weight children, odds of ICU admission were higher in children who were overweight (adjusted odds ratio [aOR], 1.7; 95% confidence interval [CI], 1.1-2.8) or obese (aOR, 2.1; 95% CI, 1.4-3.2), and odds of mechanical ventilation were higher in children with obesity (aOR, 2.7; 95% CI, 1.3-5.6). When stratified by asthma (presence/absence), these findings remained significant only in children with asthma. Compared with normal-weight adults, odds of LOS >3 days were higher in adults who were underweight (aOR, 1.6; 95% CI, 1.1-2.4), and odds of mechanical ventilation were lowest in adults who were overweight (aOR, 0.5; 95% CI, .3-.9).
Children who were overweight or obese, particularly those with asthma, had higher odds of ICU admission or mechanical ventilation. In contrast, adults who were underweight had longer LOS. These results underscore the complex relationship between BMI and CAP outcomes.
体重指数（BMI）对社区获得性肺炎（CAP）严重程度的影响尚不清楚。
我们在疾病控制与预防中心社区肺炎病因（EPIC）研究中，调查了住院CAP患者的BMI与CAP结局（住院时间[LOS]、重症监护病房[ICU]入住率和有创机械通气）之间的关系，并对年龄、人口统计学特征、基础疾病和吸烟状况（仅针对成年人）进行了校正。
与正常体重儿童相比，超重（校正优势比[aOR]，1.7；95%置信区间[CI]，1.1 - 2.8）或肥胖（aOR，2.1；95%CI，1.4 - 3.2）儿童的ICU入住率更高，肥胖儿童的机械通气率更高（aOR，2.7；95%CI，1.3 - 5.6）。按哮喘（存在/不存在）分层时，这些发现仅在患有哮喘的儿童中仍然显著。与正常体重成年人相比，体重过轻的成年人住院时间>3天的几率更高（aOR，1.6；95%CI，1.1 - 2.4），超重成年人的机械通气几率最低（aOR，0.5；95%CI，0.3 - 0.9）。
超重或肥胖的儿童，尤其是患有哮喘的儿童，ICU入住或机械通气的几率更高。相比之下，体重过轻的成年人住院时间更长。这些结果强调了BMI与CAP结局之间的复杂关系。
