Obese Senior Citizens More Likely to
Survive Deadly Sepsis Infection
Study suggest that excess weight may
cause the body to respond differently to critical illness
6, 2014 – It is not often we see good health news for fat senior
citizens. The University of Michigan Health System claims, however, that
obese senior citizens in Medicare were more likely to survive
life-threatening sepsis infection than other patients.
In a study of 1,404 Medicare
beneficiaries, heavier patients were more likely to survive the
life-threatening infection that can lead to a stay in a hospital’s
intensive care unit.
The findings, published in the
August issue of
Critical Care Medicine,
raise interesting questions about how obesity impacts the body’s
response to infection.
Obesity is most often connected
with worse, not better, health outcomes.
About BMI Measurement
The National Heart, Lung, and Blood Institute (NHLBI) has classified
overweight people into groups based on Body Mass Index (BMI is the body
weight in kilograms divided by the body height in meters squared):
Overweight = BMI 25-29.9
Class I obesity = BMI 30.0-34.9
Class II obesity = BMI 35.0-39.9
Class III (Extreme) Obesity = BMI ≥ 40.0
By these definitions, approximately 27% of
the US population is obese and an additional 34% is overweight. Obesity
is more common in women and a BMI in the overweight range is more common
Obesity is especially common in African Americans, Native
Americans, Native Hawaiians, and some Hispanic populations.
Data for the extent of obesity in the Medicare population indicate that
in 1999-2000, 33% of men and 39% of women aged 65-74 were obese as were
20% and 25% respectively over the age of 74.
Radiographic imaging exposes relationship between
obesity and cancer in aging population; women with more overall fat
mass, more visceral fat had a higher risk of cancer; fat puts older men
at risk even with healthy BMI
“Our study indicates obese sepsis
patients actually have lower mortality and similar functional outcomes
as normal weight patients.”
The focus of the study was to
investigate the association of body mass index to survival, health care
use and functional deficiencies following a severe sepsis
The last objective was selected
because of the value patients place on living and functioning
The incidence of sepsis has doubled
in the past 15 years leading to an increased focus on research and
Medicare spending. Severe sepsis causes a million hospitalizations
yearly among Medicare beneficiaries.
These hospitalizations cost more
than $16 billion annually, which is roughly 4 times the cost of
hospitalizations for heart attacks. Half of patients hospitalized with
severe sepsis die within a year.
The patients who survive often
become debilitated during their hospital stay and need to spend time in
a rehabilitation facility.
“Obese patients who survive their
sepsis hospitalization use more health care resources and require more
Medicare spending – but this apparent increase in resource use is a
result of living longer, not increased use per day alive,” says senior
Theodore Iwashyna, M.D.,
Ph.D., assistant professor of internal medicine at the U-M Health
Authors note there are many health
benefits to maintaining a normal weight, but the findings suggest that
excess weight may cause the body to respond differently to critical
illness. A better understanding of this difference may help health care
providers improve care for all patients with sepsis and other critical
The study was conducted with
participants of the Health and Retirement Study, a nationally
representative sample of older Americans that is run by the University
of Michigan Institute for Social Research on behalf of the National
Institute of Aging.
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