Atamna Alaa, Khalaila Manar, Babich Tanya, Zriek Anan, Ben Zvi Haim, Ayada Gida, Elis Avishay, Bishara Jihad, Nutman Amir
Infectious Diseases Unit, Rabin Medical Center, Beilinson Hospital, 39 Jabotinsky Road, Petah-Tikva 49100, Israel.
Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv 69978, Israel.
J Clin Med. 2025 Aug 3;14(15):5459. doi: 10.3390/jcm14155459.
Studies have demonstrated a positive correlation between high body mass index (BMI) and an increased risk of infection (CDI), independent of antibiotic usage or healthcare exposures. To compare the outcomes of obese (BMI ≥ 30 kg/m) and non-obese (BMI < 30 kg/m) hospitalized patients with CDI. This retrospective cohort study included patients with CDI hospitalized in Beilinson hospital between January 2013 and January 2020. The primary outcome was 90-day all-cause mortality. Secondary outcomes included 30-day mortality, colectomy, intensive care unit (ICU) admission and length of hospital stay (LOS). Multivariate analysis was performed to identify the risk factors independently associated with 90-day mortality. The study included 889 patients: 131 (15%) obese and 758 (85%) non-obese. The obese group was younger (median age 65 years vs. 73 years ( < 0.01)) and with a higher rate of diabetes mellitus (57/131 (44%) vs. 180/758 (24%) ( < 0.01)). The 90-day mortality was lower in the obese group: 19/131 (15%) vs. 170/752 (23%) ( = 0.04). The 30-day mortality was 8/131 (6%) vs. 96/757 (13%) ( = 0.03). ICU admission was 9/131 (7%) vs. 23/758 (3%) ( = 0.03), and median LOS was 19 vs. 12 days ( < 0.01) in obese and non-obese groups, respectively. In the multivariable analysis, after adjustment for age, Charlson's comorbidity index ≥3, assistance in activities of daily living, treatment with proton pump inhibitors and severity of illness, obesity was not a significant risk factor for 90-day mortality (OR = 0.65, 95% CI: 0.38-1.01; = 0.1). In this study, obesity was not significantly associated with 90-day mortality after adjustment for other risk factors; however, ICU admission was higher and LOS longer in this group.
研究表明，高体重指数（BMI）与艰难梭菌感染（CDI）风险增加之间存在正相关，且与抗生素使用或医疗暴露无关。为比较肥胖（BMI≥30kg/m²）和非肥胖（BMI<30kg/m²）的CDI住院患者的结局。这项回顾性队列研究纳入了2013年1月至2020年1月在贝林森医院住院的CDI患者。主要结局是90天全因死亡率。次要结局包括30天死亡率、结肠切除术、重症监护病房（ICU）入住率和住院时间（LOS）。进行多变量分析以确定与90天死亡率独立相关的风险因素。该研究纳入了889例患者：131例（15%）肥胖患者和758例（85%）非肥胖患者。肥胖组患者更年轻（中位年龄65岁对73岁（P<0.01）），糖尿病患病率更高（57/131（44%）对180/758（24%）（P<0.01））。肥胖组的90天死亡率更低：19/131（15%）对170/752（23%）（P=0.04）。30天死亡率分别为8/131（6%）对96/757（13%）（P=0.03）。ICU入住率分别为9/131（7%）对23/758（3%）（P=0.03），肥胖组和非肥胖组的中位住院时间分别为19天和12天（P<0.01）。在多变量分析中，在调整年龄、查尔森合并症指数≥3、日常生活活动协助、质子泵抑制剂治疗和疾病严重程度后，肥胖不是90天死亡率的显著风险因素（比值比=0.65，95%置信区间：0.38-1.01；P=0.1）。在本研究中，在调整其他风险因素后，肥胖与90天死亡率无显著相关性；然而，该组的ICU入住率更高，住院时间更长。
