 |
|
Body Mass Index and Mortality Among Hospitalized Patients
Francesco Landi, MD, PhD;
Graziano Onder, MD;
Giovanni Gambassi, MD;
Claudio Pedone, MD;
PierUgo Carbonin, MD;
Roberto Bernabei, MD;
for the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) Study Group
Arch Intern Med. 2000;160:2641-2644.
Background Body mass index (weight in kilograms divided by the square of the height in meters [BMI]) is known to be associated with overall mortality. However, the effect of age on excess mortality from all causes associated with obesity is controversial. The aim of the present study is to determine the effect of age on the relationship between BMI and mortality.
Methods We analyzed data from a large collaborative observational study group, the Italian Group of Pharmacoepidemiology in the Elderly (GIFA), that collected data on hospitalized patients. A total of 18,316 patients consecutively admitted to 79 clinical centers during 5 different surveys in 1998, 1991, 1993, 1995, and 1997 were enrolled in the present study. The main outcome measure was the relative hazard ratio of death for different levels of BMI.
Results Mortality rate was lowest among men and women with BMIs from 25.0 through 27.4 kg/m2 (relative risk, 0.24; 95% confidence interval, 0.15-0.38). The graphed relationship between BMI and mortality in younger patients was hyperbolic, with increased death rates at the lowest and highest BMI rankings. On the contrary, the older patients showed an increased death rate at the lowest BMIs with only a slight elevation at the highest BMIs (>35 kg/m2).
Conclusions Our results suggest that BMI, a simple anthropometric measure of nutritional status, is an important predictor of mortality among young and old hospitalized patients. Even when controlling for clinical and functional variables, a low BMI remained a significant and independent predictor of shortened survival. Furthermore, the finding of the high BMI associated with minimum hazard in elderly subjects supports some past findings and opposes others and, if confirmed, has important implications for geriatric clinical guidelines.
From the Istituto di Medicina Interna e Geriatria, Universitá Cattolica del Sacro Cuore, Rome, Italy (Drs Landi, Onder, Gambassi, Pedone, Carbonin, and Bernabei); and the Center for Gerontology and Health Care Research, Brown University, Providence, RI (Dr Gambassi). A complete list of the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) investigators has been published previously (Eur J Epidemiol. 1999;15:893-901).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Body mass index, weight change and mortality risk in a prospective study in India
Sauvaget et al.
Int J Epidemiol 2008;0:dyn059v1-dyn059.
ABSTRACT
| FULL TEXT
Comprehensive Geriatric Assessment for Older Patients With Cancer
Extermann and Hurria
JCO 2007;25:1824-1831.
ABSTRACT
| FULL TEXT
Total serum cholesterol and recovery from disability among hospitalized older adults.
Onder et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2006;61:736-742.
ABSTRACT
| FULL TEXT
Predictors of mortality and morbidity in patients with chronic heart failure
Pocock et al.
Eur Heart J 2006;27:65-75.
ABSTRACT
| FULL TEXT
Elderly Patients With Cognitive Impairment Have a High Risk for Functional Decline During Hospitalization: The GIFA Study
Pedone et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2005;60:1576-1580.
ABSTRACT
| FULL TEXT
Obese ICU Patients: Resource Utilization and Outcomes
Winkelman and Maloney
Clin Nurs Res 2005;14:303-323.
ABSTRACT
The phenomenon of altered risk factor patterns or reverse epidemiology in persons with advanced chronic kidney failure
Kopple
Am. J. Clin. Nutr. 2005;81:1257-1266.
ABSTRACT
| FULL TEXT
Survival advantages of obesity in dialysis patients
Kalantar-Zadeh et al.
Am. J. Clin. Nutr. 2005;81:543-554.
ABSTRACT
| FULL TEXT
Effect of body size on operative risk of carotid endarterectomy
Messe et al.
J. Neurol. Neurosurg. Psychiatry 2004;75:1759-1761.
ABSTRACT
| FULL TEXT
Estimating Deaths Attributable to Obesity in the United States
Flegal et al.
Am. J. Public Health 2004;94:1486-1489.
ABSTRACT
| FULL TEXT
Reverse epidemiology of conventional cardiovascular risk factors in patients with chronic heart failure
Kalantar-Zadeh et al.
J Am Coll Cardiol 2004;43:1439-1444.
ABSTRACT
| FULL TEXT
Impact of Body Mass Index on Outcomes Following Critical Care
Tremblay and Bandi
Chest 2003;123:1202-1207.
ABSTRACT
| FULL TEXT
Other Articles Noted
Evid. Based Nurs. 2001;4:E1-11.
FULL TEXT
Body Mass Index and Mortality Among Hospitalized Elderly Patients
Kamel et al.
Arch Intern Med 2001;161:1459-1460.
FULL TEXT
|
