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March 03, 2023
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Patients with obesity at higher risk for near-fatal asthma events

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SAN ANTONIO — Patients with asthma and obesity had an increased risk for near-fatal asthma events and extended hospitalization compared with those who were not obese, a recent study showed.

The findings were presented in a poster at the American Academy of Allergy, Asthma & Immunology Annual Meeting.

Obesity
Compared with patients that were not obese, patients with obesity and asthma that experienced exacerbations had a greater increase of near-fatal asthma attacks, as well as greater mean length of hospital stay. Image: Adobe Stock.

“Obesity is a known important risk factor for development of asthma as well as asthma morbidity, but large-scale epidemiology studies are lacking,” Karl Mueller, MD, PhD, a resident at the Mayo Clinic College of Science and Medicine in Florida, told Healio. “That’s one of the main drivers that led us to do this study.”

In their retrospective review, the researchers examined National Inpatient Sample data on 677,591 patients aged 5 years and older (mean age, 47 years) who had an asthma exacerbation from 2005 to 2014. Sixty-six percent of patients were women and 52% were white.

The researchers defined near-fatal asthma events as those “that led to either tracheostomy, cardiac or pulmonary arrest,” Mueller said.

Overall, 125,095 patients had obesity, 937 experienced near-fatal asthma events and 2,538 patients died.

Compared with patients without obesity, those with obesity had increases in:

  • mean length of hospital stay (4.2 vs. 3.5 days);
  • mean total direct cost ($24,550 vs. $18,973); and
  • near-fatal asthma events (0.2% vs. 0.1%).

“It’s known that for patients who are obese and have cardiac risks, [physicians] recommend they decrease their weight, or for patients who have diabetes and were overweight,” Mueller said. “Now they should start thinking about asthma as one of those conditions as well.”

Understanding the underlying causes of worse asthma exacerbations in patients with obesity is an important goal for future research, Mueller said.

“Is it due to the fact that they are having more obesity-related lung conditions like obstructed sleep apnea or obesity hypoventilation syndrome?” he asked. “Or is there actually altered immunometabolism leading to resistance of our conventional therapies, leading to this increased risk that we’re seeing?”