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ワカバヤシ ヒデタカ
Wakabayashi Hidetaka
若林 秀隆 所属 医学部 医学科（東京女子医科大学病院） 職種 教授・基幹分野長 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Impact of Body Mass Index on Activities of Daily Living in Inpatients with Acute Heart Failure. |
| 掲載誌名 | 正式名：The journal of nutrition, health & aging 略 称：J Nutr Health Aging ISSNコード：17604788/12797707 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 23(2),pp.151-156 |
| 著者・共著者 | Wakabayashi Hidetaka, Maeda Keisuke, Nishioka Shinta, Shamoto Hiroshi, Momosaki Ryo |
| 担当区分 | 筆頭著者,責任著者 |
| 発行年月 | 2019 |
| 概要 | OBJECTIVES:To investigate the impact of body mass index on activities of daily living in inpatients with acute heart failure.DESIGN:A retrospective cohort study.SETTING:A hospital-based database contains Diagnosis Procedure Combination survey data from 100 participating acute-care hospitals.PARTICIPANTS:11,301 inpatients aged 20 year or older who were admitted to the participating hospitals with a diagnosis of acute heart failure.MEASUREMENTS:The Barthel Index score at discharge and hospital death.RESULTS:The number of patients with a body mass index of <18.5 kg/m2 (underweight), 18.5-22.9 kg/m2 (low-normal weight), 23.0-24.9 kg/m2 (high-normal weight), 25.0-29.9 kg/m2 (overweight), and ≥30.0 kg/m2 (obesity) were 1689 (15%), 4715 (42%), 1809 (16%), 2306 (20%), and 782 (7%), respectively. Median Barthel Index scores at admission and discharge were 65 and 100, respectively. Hospital death occurred in 101 (0.9%) patients. Lower body mass index was associated with lower Barthel Index score at discharge and higher mortality. Multivariable analysis adjusted for body mass index, age, sex, New York Heart Association classification, Barthel Index score at admission, the updated Charlson Comorbidity Index, length of hospital stay, number of drugs administered, and rehabilitation during hospitalization revealed that body mass index was independently associated with Barthel Index score at discharge (beta: 0.354; 95% confidence interval: 0.248-0.461) and hospital death (odds ratio: 0.926, 95% confidence interval: 0.877-0.978).CONCLUSION:Overweight and obese inpatients showed greater independence in activities of daily living at discharge and lower rates of mortality, indicating the obesity paradox. A combination of rehabilitation and improved nutrition seems to be important in underweight patients with acute heart failure. |
| DOI | 10.1007/s12603-018-1111-8 |
| PMID | 30697624 |