The obesity paradox in community-acquired bacterial pneumonia

Int J Infect Dis. 2011 Jan;15(1):e54-7. doi: 10.1016/j.ijid.2010.09.011. Epub 2010 Nov 20.


Background: The impact of obesity on the outcome of pneumonia is uncertain.

Methods: We retrospectively identified 266 hospitalized patients with proven pneumococcal or Haemophilus community-acquired pneumonia who had at least one body mass index (BMI, kg/m²) value documented in the 3 months before admission. Patients were classified as underweight (BMI <18.5), normal weight (BMI 18.5 to <25), overweight (BMI 25 to <30), or obese (BMI ≥30). The association of absolute BMI values and BMI categories with the mortality at 30 days after admission for pneumonia was investigated.

Results: Increasing BMI values were associated with reduced 30-day mortality, even after adjustment for significant covariates (odds ratio 0.88, confidence interval 0.81-0.96; p<0.01). There was a significant trend towards lower mortality in the overweight and obese (non-parametric trend, p=0.02).

Conclusions: Our data suggest that obesity may exert a protective effect against 30-day mortality from community-acquired bacterial pneumonia.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Body Mass Index
  • Community-Acquired Infections / epidemiology
  • Comorbidity
  • Haemophilus Infections / epidemiology*
  • Humans
  • Middle Aged
  • Mortality
  • Obesity / epidemiology*
  • Overweight / epidemiology*
  • Pneumonia, Pneumococcal / epidemiology*
  • Retrospective Studies
  • Thinness / epidemiology*