Obesity is directly linked to multiple co-morbidities, increased morbidity, and a significant economic burden on healthcare. But the ‘obesity paradox’ advocates reduced mortality among obese vs non-obese patients in various chronic medical conditions.

A study investigated the role of obesity relating to inpatient mortality, length of stay (LOS) and costs in patients with cirrhosis. 

Analysis of the Data collected from all cases with a primary, secondary or tertiary discharge diagnosis of cirrhosis was done. Inpatient mortality, LOS, and hospital charges were the measured outcomes. 

The following observations were made-

• 32,605 patients were enrolled on the study. 
• Obese cirrhotic patients demonstrated lower Crude mortality than non-obese cirrhotic patients (2.7% vs 3.5 %). 
• Obese cirrhotic patients demonstrated longer median LOS (4 vs 3 days) and higher median hospital charges ($26 803 vs $23 447) than non-obese cirrhotic patients.
• Multivariate logistic regression demonstrated obesity to be related to a lower risk of inpatient mortality.

Thus it was concluded that in the acute care setting, obese patients with cirrhosis have lower mortality than non-obese patients with cirrhosis, longer hospitalizations and higher healthcare cost. This information furnishes new validation for the obesity paradox in cirrhosis. This may be due to having enhanced nutritional reserve which may help in survival during acute illness.

Source: Liver International, 2016;36(10):1450-1456