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Dose-response relationship between weight status and clinical outcomes in pediatric influenza-related respiratory infections

tetano

Editor, Senior Moderator
Pediatr Pulmonol. 2017 Dec 19. doi: 10.1002/ppul.23927. [Epub ahead of print]
[h=1]Dose-response relationship between weight status and clinical outcomes in pediatric influenza-related respiratory infections.[/h] Okubo Y[SUP]1,[/SUP][SUP]2[/SUP], Michihata N[SUP]3[/SUP], Uda K[SUP]4[/SUP], Morisaki N[SUP]1[/SUP], Miyairi I[SUP]4[/SUP], Matsui H[SUP]5[/SUP], Fushimi K[SUP]6[/SUP], Yasunaga H[SUP]5[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] 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.
[h=4]METHODS:[/h] 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.
[h=4]RESULTS:[/h] 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).
[h=4]CONCLUSION:[/h] These findings demonstrated that underweight status is a risk factor for repeated hospital admissions because of influenza-related respiratory infections in children.
? 2017 Wiley Periodicals, Inc.


[h=4]KEYWORDS:[/h] children; diagnosis procedure combination inpatient database; influenza; underweight

PMID: 29265591 DOI: 10.1002/ppul.23927
 
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