title: Association between body mass index and in-hospital outcomes: Analysis of the nationwide inpatient database.
abstract: OBJECTIVE
  Over one-third of American adults (36%) are obese and more than two-thirds (69%) are overweight. The impact of obesity on hospitalization outcomes is not well understood.
  
  
  OBJECTIVE
  To examine the association between body mass index (BMI) and overall, cancer, chronic obstructive pulmonary disease (COPD), asthma, and cardiovascular disease (CVD)-specific in-hospital mortality; postsurgical complications; and hospital length of stay (LOS).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Representative sample of US hospitals included in the Health Cost and Utilization Project Nationwide Inpatient Sample database.
  
  
  METHODS
  We obtained data for patients admitted with a primary diagnosis of cancer, COPD, asthma, and CVD.
  
  
  RESULTS
  In-hospital mortality, postsurgical complications, and hospital LOS.
  
  
  RESULTS
  A total of 800,417 patients were included in this analysis. A higher proportion of Blacks (26.8%; 12.5%) and Whites (23.3%; 8.7%) had BMI of 40 to 49.9 and ≥50, respectively, compared with Hispanics (20.4%; 7.3%). Compared with normal BMI patients, the odds of in-hospital mortality increased 3.6-fold (odds ratio [OR] 3.62, 95% confidence interval [CI]: 3.37-3.89) for preobese patients, 6.5-fold (OR: 6.52, 95% CI: 5.79-7.34) for patients with BMI: 30 to 31.9, 7.5-fold (OR: 7.57, 95% CI: 6.67-8.59) for patients with BMI: 34 to 35.9, and 1.6- fold (OR: 1.77, 95% CI: 1.56-1.79) for patients with BMI ≥ 50. Compared with normal BMI patients, preobese and overweight patients had shorter hospital stays (β preobese: -1.58, 95% CI: -1.63, -1.52); however, no clear trends were observed for postsurgical complications.
  
  
  CONCLUSIONS
  The majority of hospitalized patients in this analysis had a BMI > 30, and higher BMI was associated with increased risk of mortality and longer hospital stay.
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama University of Northern Colorado Cancer Rehabilitation Institute, Greeley, Colorado School of Social Work, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado, USA.
authors.forename: Tomi
authors.initials: T
authors.lastname: Akinyemiju
authors.forename: Qingrui
authors.initials: Q
authors.lastname: Meng
authors.forename: Neomi
authors.initials: N
authors.lastname: Vin-Raviv
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000401:mortality / Q000628:therapy; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000401:mortality / Q000628:therapy; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000628:therapy; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality / Q000628:therapy; D012307:Risk Factors; D014481:United States / Q000453:epidemiology