Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
PLoS One. 2018 Apr 16;13(4):e0195853. doi: 10.1371/journal.pone.0195853. eCollection 2018.
Data are sparse on the range of BMI among patients acutely admitted to general hospitals. We investigated BMI values and associated patient characteristics, reasons for hospital admission, and mortality in Denmark.
We identified all persons with an acute inpatient admission 2011-2014 in Central Denmark Region and assessed BMI measurements recorded in the Clinical Information System. We used cross-sectional and cohort analyses to examine the BMI distribution and its association with demographic characteristics, comorbidities, medication use, tobacco smoking, reasons for admission, and 30-day mortality.
Among 92,027 acutely admitted patients (median age 62 years, 49% female) with a BMI measurement, 4% had a BMI (kg/m2) <18.5, 42% a BMI between 18.5 and 25, 34% a BMI between 25 and 30, and 20% a BMI ≥30. Compared with normal-weight patients, 30-day mortality was high among patients with BMI <18.5 (7.5% vs. 2.8%, age- and smoking-adjusted odds ratio (aOR) 2.4; 95% confidence interval (CI): 2.0-2.9, whereas patients with overweight (aOR 0.7; 95% CI: 0.6-0.8) and obesity class I (aOR 0.8; 95% CI: 0.6-0.9)). Compared with the total population, patients with BMI <18.5 were older (68 years median); more were female (73%); more had comorbidities (Charlson Comorbidity Index score >0 in 42% vs. 33% overall), more were current smokers (45% vs. 27% overall), and acute admissions due to respiratory diseases or femoral fractures were frequent. In contrast, patients with BMI ≥30 were relatively young (59 years median), fewer smoked (24%): type 2 diabetes, sleep disorders, cholelithiasis, and heart failure were frequent diagnoses. Prevalence of therapies for metabolic syndrome, pain, and psychiatric disorders increased with higher BMI, while patients with BMI <18.5 frequently used asthma medications, glucocorticoids, and antibiotics.
In patients acutely admitted to general hospitals, reasons for hospital admission and associated clinical characteristics differ substantially according to BMI range. BMI <18.5 is a clinical predictor of high short-term mortality.
有关住院患者体重指数（BMI）范围的数据较为匮乏。我们对丹麦住院患者的 BMI 值及其相关特征、入院原因、死亡率进行了研究。
我们在丹麦中地区确定了所有在 2011-2014 年期间接受急性住院治疗的患者，并评估了临床信息系统中记录的 BMI 测量值。我们使用横断面和队列分析方法，研究 BMI 分布及其与人口统计学特征、合并症、药物使用、吸烟、入院原因和 30 天死亡率的关系。
在 92027 名接受急性入院治疗（中位年龄 62 岁，49%为女性）且有 BMI 测量值的患者中，4%的 BMI（kg/m2）<18.5，42%的 BMI 在 18.5 至 25 之间，34%的 BMI 在 25 至 30 之间，20%的 BMI ≥30。与正常体重患者相比，BMI<18.5 的患者 30 天死亡率较高（7.5% vs. 2.8%，年龄和吸烟调整后的比值比（aOR）2.4；95%置信区间（CI）：2.0-2.9），而超重患者（aOR 0.7；95%CI：0.6-0.8）和肥胖 I 级患者（aOR 0.8；95%CI：0.6-0.9）。与总人口相比，BMI<18.5 的患者年龄更大（中位年龄 68 岁），女性更多（73%），合并症更多（Charlson 合并症指数评分>0 占 42%，而总体占 33%），当前吸烟者更多（45% vs. 27%），因呼吸系统疾病或股骨骨折入院的情况更为常见。相比之下，BMI≥30 的患者相对年轻（中位年龄 59 岁），吸烟较少（24%），2 型糖尿病、睡眠障碍、胆结石和心力衰竭等诊断更为常见。代谢综合征、疼痛和精神疾病治疗的患病率随 BMI 增加而增加，而 BMI<18.5 的患者经常使用哮喘药物、糖皮质激素和抗生素。
在因急性病住院的患者中，入院原因和相关临床特征根据 BMI 范围有很大差异。BMI<18.5 是短期死亡率高的临床预测指标。
