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Obesity and underweight are associated with an increased risk of death after lung transplantation.
- Source :
-
American journal of respiratory and critical care medicine [Am J Respir Crit Care Med] 2009 Nov 01; Vol. 180 (9), pp. 887-95. Date of Electronic Publication: 2009 Jul 16. - Publication Year :
- 2009
-
Abstract
- Rationale: Obesity is considered a relative contraindication to lung transplantation, based on studies that have not accounted for key confounders. Little is known about the risk of death for underweight candidates after transplantation.<br />Objectives: To examine the associations of pretransplant obesity and underweight with the risk of death after lung transplantation.<br />Methods: We examined 5,978 adults with cystic fibrosis, chronic obstructive pulmonary disease, and diffuse parenchymal lung disease who underwent lung transplantation in the United States between 1995 and 2003. We used Cox models and generalized additive models to examine the association between pretransplant body mass index and the risk of death after lung transplantation with adjustment for donor and recipient factors.<br />Measurements and Main Results: The median follow-up time was 4.2 years. Compared with normal weight recipients, the multivariable-adjusted rates of death were 15% higher for underweight recipients (95% confidence interval, 3 to 28%), 15% higher for overweight recipients (95% confidence interval, 6 to 26%), and 22% higher for obese recipients (95% confidence interval, 8 to 39%). These relationships persisted when stratified by diagnosis. The multivariable-adjusted population attributable fraction was 12% at 1 year and 8% at 5 years.<br />Conclusions: Both obesity and underweight are independent risk factors for death after lung transplantation, contributing to up to 12% of deaths in the first year after transplantation. Primary care providers and pulmonologists should promote a healthy weight for patients with lung disease long before transplantation is considered.
- Subjects :
- Adult
Body Mass Index
Cohort Studies
Female
Follow-Up Studies
Graft Rejection complications
Humans
Lung Diseases mortality
Lung Diseases surgery
Male
Middle Aged
Obesity mortality
Odds Ratio
Respiratory Insufficiency complications
Retrospective Studies
Risk Factors
Survival Analysis
Thinness mortality
United States
Lung Diseases complications
Lung Transplantation mortality
Obesity complications
Thinness complications
Subjects
Details
- Language :
- English
- ISSN :
- 1535-4970
- Volume :
- 180
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- American journal of respiratory and critical care medicine
- Publication Type :
- Academic Journal
- Accession number :
- 19608717
- Full Text :
- https://doi.org/10.1164/rccm.200903-0425OC