Body mass index and in-hospital mortality in patients with acute exacerbation of idiopathic pulmonary fibrosis
- Nobuyasu Awano1⇑,
- Taisuke Jo2,3,
- Hideo Yasunaga4,
- Minoru Inomata1,
- Naoyuki Kuse1,
- Mari Tone1,
- Kojiro Morita4,5,
- Hiroki Matsui4,
- Kiyohide Fushimi6,
- Takahide Nagase3 and
- Takehiro Izumo1
- 1Department of Respiratory Medicine, Japanese Red Cross Medical Center, Tokyo, Japan
- 2Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- 3Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- 4Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
- 5Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
- 6Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
- Nobuyasu Awano, Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan. E-mail: awanobu0606{at}hotmail.co.jp
Abstract
Background Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease characterised by chronic fibrosis, and acute exacerbation of IPF (AE-IPF) is the leading cause of death in patients with IPF. Data on the association between the body mass index (BMI) and prognosis of AE-IPF are lacking. This study was performed to evaluate the association between the BMI and in-hospital mortality in patients who developed AE-IPF using a national inpatient database.
Methods Using the Japanese Diagnosis Procedure Combination database, we retrospectively collected data of inpatients with AE-IPF from July 1, 2010 to March 31, 2018. We performed a multivariable logistic regression analysis to evaluate the association between all-cause in-hospital mortality and the BMI, categorised as underweight (<18.5 kg·m−2), low-normal weight (18.5–22.9 kg·m−2), high-normal weight (23.0–24.9 kg·m−2), overweight (25.0–29.9 kg·m−2), and obese (≥30.0 kg·m−2).
Results In total, 14,783 patients were eligible for this study. The in-hospital mortality rate was 59.0%, 55.0%, 53.8%, 54.8%, and 46.0% in the underweight, low-normal weight, high-normal weight, overweight, and obese groups, respectively. Underweight patients had a significantly higher mortality rate (odds ratio, 1.25; 95% confidence interval, 1.10–1.42) and obese patients had a significantly lower mortality rate (odds ratio, 0.71; 95% confidence interval, 0.54–0.94) than low-normal weight patients.
Conclusion Among patients with AE-IPF, the underweight group had higher mortality and the obese group had lower mortality.
Footnotes
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Conflict of interest: Dr. Awano has nothing to disclose.
Conflict of interest: Dr. Jo has nothing to disclose.
Conflict of interest: Dr. Yasunaga reports grants from The Ministry of Health, Labour and Welfare, Japan, grants from The Ministry of Education, Culture, Sports, Science and Technology, Japan, during the conduct of the study.
Conflict of interest: Dr. Inomata has nothing to disclose.
Conflict of interest: Dr. Kuse has nothing to disclose.
Conflict of interest: Dr. Tone has nothing to disclose.
Conflict of interest: Dr. Morita has nothing to disclose.
Conflict of interest: Dr. Matsui has nothing to disclose.
Conflict of interest: Dr. Fushimi has nothing to disclose.
Conflict of interest: Dr. Nagase has nothing to disclose.
Conflict of interest: Dr. Izumo has nothing to disclose.
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- Received January 19, 2021.
- Accepted April 12, 2021.
- Copyright ©The authors 2021
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