title: Obesity is associated with higher risk of intensive care unit admission and death in influenza A (H1N1) patients: a systematic review and meta-analysis.
abstract: The aim of this study was to assess the association between obesity and the risk of intensive care unit (ICU) admission and death among patients hospitalized for influenza A (H1N1) viral infection. A systematic review of the Medline and Cochrane databases using 'obesity', 'hospitalization', 'influenza A viral infection', various synonyms, and reference lists of retrieved articles from January 2009 to January 2010. Studies comparing the prevalence of obesity among patients with confirmed infection for influenza A virus and who were either hospitalized or admitted to ICU/died were included. A total of 3059 subjects from six cross-sectional studies, who were hospitalized for influenza A (H1N1) viral infection, were included in this meta-analysis. Severely obese H1N1 patients (body mass index ≥ 40 kg m(-2), n = 804) were as twice as likely to be admitted to ICU or die (odds ration: 2.01, 95% confidence interval: 1.29-3.14, P < 0.002) compared with H1N1 patients who were not severely obese. Having a body mass index ≥ 30 kg m(-2) was similarly associated with a more than twofold increased risk of ICU admission or death although this did not reach statistical significance (2.14, 0.92-4.99, P < 0.07). This meta-analysis supports the view that obesity is associated with higher risks of ICU admission or death in patients with influenza A (H1N1) infection. Therefore, morbid obese patients should be monitored more intensively when hospitalized.
authors: Nutritional Epidemiology Research Unit-UMR U557 INSERM, U1125 INRA, CNAM, Paris 13 University, Bobigny, France.
authors: L
authors: L
authors: Fezeu
authors: C
authors: C
authors: Julia
authors: A
authors: A
authors: Henegar
authors: J
authors: J
authors: Bitu
authors: F B
authors: FB
authors: Hu
authors: D E
authors: DE
authors: Grobbee
authors: A-P
authors: AP
authors: Kengne
authors: S
authors: S
authors: Hercberg
authors: S
authors: S
authors: Czernichow
mesh_terms: D015992:Body Mass Index; D003430:Cross-Sectional Studies; D006760:Hospitalization; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications / Q000401:mortality* / Q000503:physiopathology*; D007362:Intensive Care Units; D016239:MEDLINE; D009765:Obesity / Q000150:complications*; D009767:Obesity, Morbid / Q000150:complications; D012307:Risk Factors