Impact of Body Mass Index on Activities of Daily Living in Patients with Idiopathic Interstitial Pneumonias.

Hidetaka Wakabayashi,Ryo Momosaki,Kengo Shirado,Keisuke Maeda

doi:10.3390/healthcare8040385

Abstract

In patients with idiopathic interstitial pneumonias, undernutrition has a profound effect on prognosis. However, whether body mass index affects the ability to perform activities of daily living as measured by the Barthel index in patients with idiopathic interstitial pneumonias remains unknown. Therefore, we examined the impact of body mass index on the activities of daily living in inpatients with idiopathic interstitial pneumonia. We used a database constructed by the Japan Medical Data Center. Data were extracted from 2774 inpatients from participating hospitals with a diagnosis of idiopathic interstitial pneumonia. Multiple regression analysis adjusted for confounding factors was performed to determine whether body mass index classification would be independently related to change in Barthel index during hospitalization. Underweight, normal weight, overweight, and obesity numbered 473 (19%), 1037 (41), 795 (31%), and 235 (9%), respectively. Multivariable analysis showed that being underweight was independently associated with a change in Barthel index during hospitalization of −2.95 (95% confidence interval −4.82 to −1.07) points lower than being normal weight. Approximately 20% of the patients with idiopathic interstitial pneumonias were underweight. Those who were underweight had decreased independence in activities of daily living during hospitalization.

Highlights

Patients with idiopathic interstitial pneumonias commonly have low body mass index (BMI), which can lead to poor outcomes
There were 4233 inpatients with idiopathic interstitial pneumonia in the JMDC diagnosis procedure combination (DPC) database over the study period. It excluded 3 patients
We examined the impact of BMI on activities of daily living in inpatients with idiopathic interstitial pneumonias

Summary

Introduction

Patients with idiopathic interstitial pneumonias commonly have low body mass index (BMI), which can lead to poor outcomes. A cohort study conducted in the United States found that in patients with idiopathic pulmonary fibrosis, lower BMI was associated with shorter survival [1]. BMI less than 18.5 kg/m2 is independently associated with mortality [2]. These findings demonstrate that, in patients with idiopathic interstitial pneumonias, undernutrition has a profound effect on prognosis. There are various controversies about applying international standards for obesity to Asian populations, and World Health Organization (WHO) expert consultations have identified cut-offs for BMI in public health in Asia and the Pacific [3], but few reports have been validated using them.

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