RESUMO
Background There is a scarcity of studies delineating the trends of cardiovascular interventions in the hospitalized population stratified by body mass index (BMI). Our study aimed to study the burden of cardiovascular interventions and outcomes by BMI. Methods We retrospectively analyzed the Nationwide Inpatient Sample (NIS) database between January 2016 and December 2020. We identified the population of interest using the International Classification of Diseases, Tenth Revision (ICD-10) code. We studied the BMI in five categories: "healthy weight" (HW; BMI < 19.9-24.9 kg/m2), "overweight" (OV; BMI = 25-29.9 kg/m2), "obesity class one" (OB1; BMI = 30-34.9 kg/m2), "obesity class two" (OB2; BMI = 35-39.9 kg/m2), and "obesity class three" (OB3; BMI > 40 kg/m2). Results There were 5,654,905 hospitalizations with an ICD-10 code related to BMI within this study period. The HW group had 1,103,659 (19.5%) hospitalizations, the OV group had 462,464 (8.2%), the OB1 group had 1,095,325 (19.4%), the OB2 group had 1,036,682 (18.3%), and the OB3 group had 1,956,775 (34.6%) hospitalizations. The mean age of the population with obesity was as follows: OB1 = 61 years (SD = 16); OB2 = 58 years (SD = 15.9); and OB3 = 55 years (SD = 15.5). The mean ages of the HW and OV groups were 68 years (SD = 16.6) and 65 years (SD = 16.1), respectively. In the HW group, there were 948 (8.1%) hospital admissions for aortic valve replacement (AVR), 54 (11%) for aortic valve repair (AVRr), 737 (15.9%) for mitral valve replacement (MVRr), 12 (17.1%) for mitral valve repair (MVR), 79 (2.2%) for left atrial appendage (LAA) closure, and 3390 (5.2%) for percutaneous coronary intervention (PCI). The OV group had 1049 (8.9%) hospital admissions for AVRs, 42 (9%) for AVRr, 461 (10%) for MVRr, four (5.7%) for MVR, 307 (8.6%) for LAA closure, and 5703 (8.8%) for PCIs. The OB1 group had 3326 (28.4%) hospital admissions for AVR, 125 (26.9%) for AVRr, 1229 (26.7%) for MVRr, 23 (32.9%) for MVR, 1173 (32.9%) for LAA, and 20,255 (31.3%) for PCI, while the OB2 group had 2725 (23.3%) hospital admissions for AVR, 105 (22.6%) for AVRr, 898 (19.4%) for MVRr, 11 (15.7%) for MVR, 933 (26.2%) for LAA, and 16,773 (25.9%) for PCI. Lastly, the OB3 group had 3626 (31%) hospital admissions for AVR, 139 (29.9%) for AVRr, 1285 (27.8%) for MVRr, 20 (28.6%) for MVR, 1063 (29.9%) for LAA, and 18,589 (28.7%) for PCI. Conclusion Our study supports the evidence of increased cardiovascular interventions with increasing BMI. Albeit, an inconsistent presentation across the spectrum of cardiovascular diseases and outcomes, for example, equal or better outcomes in obese cohorts compared to the healthy weight population undergoing PCI. However, the increasing cardiovascular intervention burden in the youngest studied population suggests a rise in the cardiovascular disease burden among the young and partially explains their better outcomes. Steps to include weight management for these patients are paramount.
RESUMO
BACKGROUND: The incidence of childhood obesity has received a lot of attention lately, especially in the United States. The increased prevalence of pediatric obesity and its association with comorbidities has piqued the attention of more scientists in the epidemic's patterns. Our research examined the National (Nationwide) Inpatient Sample (NIS) data set for hospitalized persons aged 18 years or younger with primary or secondary obesity between 2016 and 2019 to investigate the prevalence, risk factors, and related diseases. METHODS: We retrospectively examined individuals with primary or secondary obesity from 2016 to 2019 using the NIS database. To extract the weighted samples, we utilized the International Classification of Diseases (ICD)-10 diagnostic codes E66, E660, E6601, E6609, E662, E668, and E669. Individuals with drug-related obesity or obesity caused by a recognized pathologic disease unrelated to high-calorie intake were excluded. First, we queried the total population, then separated them by age category and picked our population of interest, i.e., those aged 18 and under. The NIS is a deidentified database available to the public. It collects data on around 8 million hospitalizations annually, accounting for roughly 20% of all admissions in the United States. Results: The findings show that between 2016 and 2019, prevalence rates of childhood obesity were still on the rise and plateaued in 2019. There were 28,484,087 study subjects in this weighted sample between 2016 and 2019. Of these, 13.9% (3,946,889) were diagnosed with obesity. The sample population for those 18 years of age or under was 62,669 (1.5%) children with obesity with a mean age of 14 (SD = 4). Also, there was a 64.2% female preponderance. The obtained yearly showed a steady and significant rise from 2016 to 2018 (24% vs. 26%), with a slight decline in 2019 (25%; p < 0.001). Even though the white population had the highest overall prevalence of childhood obesity (40.9%), the Hispanic and black people had a higher prevalence per population, with a 0.5% and 0.33% prevalence, respectively, compared to 0.14% in the white population (p < 0.0001). When geographical regions were considered, south had the highest rate (36.40%), followed by the west (24.71%) and the midwest (23.56%). The analysis also showed that people with lower median household income (0-25th percentile) had the highest rate of childhood obesity (38.17%) compared to higher-income earners (13.19%). CONCLUSION: In our finding, obesity in the pediatric population is still increasing, continuing on its previously recorded trajectory. Various recommendations from health policymakers have bolstered efforts to tackle this escalating pandemic. However, additional information on the compliance, use, and adherence to these policies by healthcare professionals and members of the public, as well as the consequence of utilization or compliance to these guidelines, is needed. Nevertheless, given the continuous growth of childhood obesity, despite the avalanche of these recommendations, the issue of compliance arises, or other essential risk factors might have been overlooked. Additional studies may be needed to unmask this looming phenomenon.
