Association of Obesity on Outcomes of Hospitalized Patients with Cerebral Palsy. Issue 12 (December 2021)

• Record Type: Journal Article
• Authors: Harris, Ché Matthew; Wright, Scott Mitchell
• Is Part Of: Southern medical journal. Volume 114:Issue 12(2021)
• Page Start: 772
• Page End: 776
• Publication Date: 2021-12
• Subjects: cerebral palsy -- hospitalizations -- large database -- obesity -- outcomes; Medicine -- Periodicals; 610.5
• DOI: 10.14423/SMJ.0000000000001328
• Languages: English
• ISSNs: 0038-4348

Abstract

Abstract : According to the Centers for Disease Control and Prevention, children and adults with disabilities are at significant risk for developing obesity and suffering from its consequences. The most common childhood disability is cerebral palsy, and given that an increasing number of children with this condition are becoming adults, it can be expected that obesity will be an additional health burden on this vulnerable patient population. This study investigated in-hospital clinical and resource utilization outcomes of adult patients with cerebral palsy comparing those with and without a secondary diagnosis of obesity. Supplemental digital content is available in the text. Abstract: Objective: Among hospitalized adults with cerebral palsy (CP), it is unknown whether obesity is associated with clinical and resource utilization outcomes. We sought to identify the association of obesity on clinical and resource utilization outcomes in this population. Methods: This retrospective cohort study analyzed years 2016 and 2017 of the Nationwide Inpatient Sample database and examined hospitalized adults with CP. Regression analyses were used to evaluate mortality and resource utilization. Results: In total, 154, 219 adults with CP were hospitalized. Among them, 13, 475 (8.7%) had a secondary diagnosis for obesity. Patients with obesity were older (mean age ± standard error of the mean: 49.9 ± 0.18 versus 44.7 ± 0.18 years, P < 0.01), a greater proportion were female (60.7% vs 43.2%, P < 0.01), and were more likely to be insured by Medicare (65.2% vs 56.2%, P < 0.01). Patients with obesity had higher comorbidity burdens (Charlson comorbidity score ≥ 3: 22.3% vs 9.8%, P < 0.01). Those with obesity had lower mortality rates (1.6% vs 2.4%; P < 0.01). After adjustment for confounders, mortality for patients with obesity remained lower (adjusted odds ratio 0.5, 95% confidence interval [CI] 0.4–0.7, P < 0.01). Hospital charges (adjusted mean difference $2499, 95% CI $6202–$1202, P = 0.18) and length of stay (adjusted mean difference 0.01 days; 95% CI −0.28 to 0.31, P = 0.93) were not significantly different between the groups. Conclusions: Obesity was associated with reduced mortality among adult patients in the hospital who had CP. This finding is consistent with the obesity paradox that has been observed repeatedly in patients with other chronic diseases. Further studies investigating hospitalized patients with CP are needed to corroborate these findings.