| アブストラクト | BACKGROUND: Associations between underweight/obesity and manifestations of influenza infection remain unclear, especially in children. This study investigated the dose-response relationships between weight status and clinical outcomes among children hospitalized with influenza-related respiratory infections. METHODS: We obtained hospital discharge records of inpatients aged under 18 years with diagnoses of bronchitis/pneumonia and influenza, using a Japanese national inpatient database. The patients were classified as underweight, normal-weight, overweight, or obese groups using weight-for-length, weight-for-height, and body-mass-index for age following World Health Organization criteria. We compared need for intensive care, 30-day readmission, mean total hospitalization costs, and length of hospital stay across the four groups using multivariable regression models and restricted cubic spline functions. RESULTS: Overall, 27 771 patients were identified, including 2637 underweight, 19 701 normal-weight, 2675 overweight, and 2758 obese patients. The underweight group showed a significantly higher 30-day readmission (adjusted odds ratio, 1.68; 95% confidence interval, 1.28-2.18) and a longer length of stay (adjusted difference, 0.23 days; 95% confidence interval, 0.12-0.23 days) than the normal-weight group did. No significant differences in the need for intensive care or hospitalization costs were observed across the four weight status groups. The threshold for a statistically significant association between weight status and 30-day readmission was a z-score for weight-for-length, weight-for-height, or BMI for age of -0.95 (17th percentile). CONCLUSION: These findings demonstrated that underweight status is a risk factor for repeated hospital admissions because of influenza-related respiratory infections in children. |
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| ジャーナル名 | Pediatric pulmonology |
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| 投稿日 | 2017/12/22 |
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| 投稿者 | Okubo, Yusuke; Michihata, Nobuaki; Uda, Kazuhiro; Morisaki, Naho; Miyairi, Isao; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo |
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| 組織名 | Department of Social Medicine, National Research Institute for Child Health and;Development, Setagaya-ku, Tokyo, Japan.;Department of Epidemiology, UCLA Fielding school of Public Health, Los Angeles,;CA.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Setagaya-ku, Tokyo, Japan.;Office for Infectious Control, National Center for Child Health and Development,;Setagaya-ku, Tokyo, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Setagaya-ku, Tokyo, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine, Setagaya-ku, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/29265591/ |
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