Underweight status in patients hospitalized with acute pulmonary embolism was associated with higher in-hospital mortality compared to normal BMI (7.8% vs 3.3%; OR 1.85, 95% CI 1.54-2.21; p<0.001).
Observational (n=904,260)
Yes
Does body mass index category impact in-hospital mortality and management in adult admissions with acute pulmonary embolism?
In patients hospitalized with acute pulmonary embolism, being underweight is associated with significantly higher in-hospital mortality and complications, while being overweight or obese is associated with lower mortality compared to normal BMI.
Odds Ratio: 1.85 (95% CI 1.54–2.21)
Absolute Event Rate: 7.8% vs 3.3%
p-value: p=<0.001
Background: Limited data exist on the impact of body mass index (BMI) on the outcomes of admissions with acute pulmonary embolism (PE). Methods: All adult (≥18 years) admissions with a primary diagnosis of PE were identified using the National Inpatient Sample (2016-2020) and categorized using BMI into underweight (24. 9 kg/m 2). Outcomes included in-hospital mortality, utilization of PE therapies, and resource utilization. Results: Of 904, 260 admissions, 1. 8%, 70. 4%, and 27. 7% were underweight, normal and overweight/obese, respectively. Underweight admissions were on average older (70. 8±0. 2, 64. 6±0. 05, 58. 2±0. 07 years), male (56. 7%, 49%, 58. 3%) with higher comorbidity (Elixhauser Index 5. 8±0. 03, 4±0. 06, 5. 1±0. 09), from a lower socioeconomic status, and with Medicare insurance compared to normal and overweight/obese categories (p<0. 001). The underweight cohort had higher rates of acute organ failure, bleeding complications, strokes, shock, and higher mechanical ventilation and hemodialysis use. In contrast to the underweight group, normal and overweight/obese groups had higher rates of mechanical thrombectomy (0. 3%, 1. 1%, 1. 9%), systemic thrombolysis (1. 5%, 2. 6%, 4. 2%), catheter directed therapy (0. 9%, 3%, 5. 8%), and surgical thrombectomy (0. 0%, 0. 1%, 0. 2%) (p<0. 001). Compared to the normal cohort (3. 3%), underweight cohort had higher (7. 8%; odds ratio OR 1. 85 95% confidence interval CI 1. 54-2. 21), whereas the overweight/obese cohort had lower (2. 2%; OR 0. 47 95% CI 0. 42-0. 52) in-hospital mortality (both p <0. 001). The underweight cohort had longer hospitalization stays, higher hospitalization costs, and were discharged home less frequently. Conclusion: Compared to those with normal BMI, underweight status was associated with worse outcomes in those hospitalization with acute PE.
Mehta et al. (Wed,) conducted a observational in Acute pulmonary embolism (n=904,260). Underweight status (BMI <19.9 kg/m2) vs. Normal BMI (19.9-24.9 kg/m2) was evaluated on In-hospital mortality (OR 1.85, 95% CI 1.54-2.21, p=<0.001). Underweight status in patients hospitalized with acute pulmonary embolism was associated with higher in-hospital mortality compared to normal BMI (7.8% vs 3.3%; OR 1.85, 95% CI 1.54-2.21; p<0.001).