Department of Critical Care Medicine, Xiehe Hospital of Dongxihu District, Wuhan People's Hospital of Dongxihu District, Wuhan, 430000, China.
Department of Respiratory, Wanbei Coal-Electricity Group General Hospital, Suzhou 234011, Anhui Province, China.
Clinics (Sao Paulo). 2019;74:e608. doi: 10.6061/clinics/2019/e608. Epub 2019 Jul 10.
The present study aimed to investigate the relationship between obesity and mortality in patients with community-acquired pneumonia (CAP) in China.
In total, 909 patients with CAP were recruited for this study from January 2010 to June 2015. All patients were selected and divided into 4 groups according to their body mass index (BMI) values. All patients' clinical information was recorded. The associations among mortality; BMI; the 30-day, 6-month and 1-year survival rates for different BMI classes; the etiology of pneumonia in each BMI group; and the risk factors for 1-year mortality in CAP patients were analyzed.
With the exception of the level of C-reactive protein (CRP), no other clinical indexes showed significant differences among the different BMI groups. No significant differences were observed among all groups in terms of the 30-d and 6-month mortality rates (p>0.05). There was a significantly lower risk of 1-year mortality in the obese group than in the nonobese group, (p<0.05). Logistic regression analysis showed that there were seven independent risk factors for 1-year mortality in CAP patients, namely, age, cardiovascular disease, cerebrovascular disease, obesity, APACHE II score, level of CRP and CAP severity.
Compared with nonobese patients with CAP, obese CAP patients may have a lower mortality rate, especially with regard to 1-year mortality, and CRP may be associated with the lower mortality rate in obese individuals than in nonobese individuals.
本研究旨在探讨中国社区获得性肺炎（CAP）患者肥胖与死亡率的关系。
本研究共纳入 2010 年 1 月至 2015 年 6 月期间的 909 例 CAP 患者。所有患者均根据体重指数（BMI）值分为 4 组。记录所有患者的临床资料。分析死亡率；BMI；不同 BMI 组患者的 30 天、6 个月和 1 年生存率；各组肺炎病因；以及 CAP 患者 1 年死亡率的危险因素之间的关系。
除 C 反应蛋白（CRP）水平外，各组间其他临床指标均无明显差异。各组间 30 天和 6 个月死亡率无明显差异（p>0.05）。肥胖组 1 年死亡率明显低于非肥胖组（p<0.05）。Logistic 回归分析显示，CAP 患者 1 年死亡率的独立危险因素有 7 个，分别为年龄、心血管疾病、脑血管疾病、肥胖、APACHE II 评分、CRP 水平和 CAP 严重程度。
与非肥胖 CAP 患者相比，肥胖 CAP 患者的死亡率可能较低，尤其是 1 年死亡率，且 CRP 可能与肥胖者死亡率低于非肥胖者有关。
