Dose-dependent relationships between weight status and clinical outcomes among infants hospitalized with respiratory syncytial virus infections.
BACKGROUND: Associations between weight status and manifestations of respiratory syncytial virus infections remain unclear, especially in infants.
OBJECTIVE: This study investigated the dose-response relationships between weight status and clinical outcomes among infants hospitalized with respiratory syncytial virus infections.
METHODS: We obtained hospital discharge records for inpatients aged <12 months with diagnoses of bronchitis/pneumonia and respiratory syncytial virus infections, using a Japanese national inpatient database. The patients were classified into underweight, normal-weight, or overweight/obese groups using weight-for-length according to World Health Organization criteria. We compared need for intensive care, 30-day readmission, mean total hospitalization costs, and length of hospital stay across the three groups using multivariable mixed-effects regression models and restricted cubic spline functions.
RESULTS: Overall, 42 698 patients were identified, comprising 3697 underweight, 35 849 normal-weight, 3152 overweight/obese patients. The underweight group had significantly higher risk of intensive care (adjusted odds ratio, 1.35; 95% confidence interval, 1.18-1.82) and longer length of stay (adjusted difference, 0.12 days; 95% confidence interval, 0.04-0.20 days) than the normal-weight group. No significant differences in 30-day readmission or hospitalization costs were observed among the three groups. The lower and upper thresholds for a significant association between weight status and intensive care were weight-for-length z-scores of -0.64 (26th percentile) and 2.08 (98th percentile), respectively.
CONCLUSIONS: These findings demonstrate that abnormal weight status is an independent risk factor for greater illness severity among infants hospitalized with respiratory syncytial virus infections.
|投稿者||Okubo, Yusuke; Morisaki, Naho; Michihata, Nobuaki; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo|
|組織名||Department of Social Medicine, National Research Institute for Child Health and;Development, Tokyo, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine, Tokyo, Japan.|