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BACKGROUND: The "obesity paradox" has been demonstrated in chronic diseases but not in acute surgery. We sought to determine whether obesity is associated with improved outcomes in patients with severe soft tissue infections (SSTIs). METHODS: The 2006 to 2010 Nationwide Inpatient Sample was used to identify adult patients with SSTIs. Patients were categorized into nonobese and obese (nonmorbid [body mass index 30 to 39.9] and morbid [body mass index ≥ 40]). Logistic regression provided risk-adjusted association between obesity categories and inhospital mortality. RESULTS: There were 2,868 records with SSTI weighted to represent 14,080 patients. Obese patients were less likely to die in hospital than nonobese patients (odds ratio [OR] = .42; 95% confidence interval [CI], .25 to .70; P = .001). Subanalysis revealed a similar trend, with lower odds of mortality in nonmorbid obesity (OR = .46; 95% CI, .23 to .91; P = .025) and morbid obesity (OR = .39; 95% CI, .19 to .80; P = .011) groups. CONCLUSIONS: Obesity is independently associated with reduced inhospital mortality in patients with SSTI regardless of the obesity classification. This suggests that the obesity paradox exists in this acute surgical population.

Original publication

DOI

10.1016/j.amjsurg.2016.05.006

Type

Journal article

Journal

Am j surg

Publication Date

09/2017

Volume

214

Pages

385 - 389

Keywords

Fournier's gangrene, Gas gangrene, Necrotizing fasciitis, Nutrition, Obesity paradox, Adolescent, Adult, Aged, Aged, 80 and over, Body Mass Index, Female, Hospital Mortality, Humans, Male, Middle Aged, Obesity, Obesity, Morbid, Severity of Illness Index, Soft Tissue Infections, Young Adult