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Female obesity

England: Female obesity results in 420,000 extra hospital admissions

Women with BMI35 were at least 11 times more likely to be admitted with diabetes

Obesity-related health problems are so prevalent among women aged 50- to 84-years old in England that they account for approximately one in eight hospital admissions in this age group. This equates to an additional 420,000 extra hospital admissions and two million extra days spent in hospital, annually, according to a study published online at BioMed Central.

“Significant increases in the risk of admission with increasing BMI were observed for 19 of the 25 types of hospital admission considered,” the authors note. “BMI was most strongly associated with admissions with diabetes, knee-replacement, gallbladder disease and venous thromboembolism, but marked associations were found with many other common categories of admission including cataracts, carpal tunnel syndrome and diverticulitis.”

The aim of the study was to assess the relationship between BMI and rates of hospital admission in middle-aged UK women, durations of hospital stay, using routinely collected hospital admission records in a large UK cohort of middle-aged women. They also sought to assess the risk of hospitalisation separately for the 25 most common categories of admission in this group of women.

They examined 1,251,619 records form the Million Women Study, who were 50- to 64-years old at entry into the study, routine data on hospital admissions were used to estimate hospitalization rates according to BMI after standardisation for age, region of recruitment, socioeconomic status, reproductive history, smoking status, hormonal therapy use and alcohol intake.

Outcomes

The results showed that during an average of 9.2 years follow-up, there were 2,834,016 incident hospital admissions. In women with BMIs of <22.5, 22.5 to <25, 25 to <30, 30 to <35 and 35+ standardized admission rates (and 95% confidence intervals (CIs)) per woman over a ten-year period were 2.4 (2.4 to 2.4), 2.4 (2.3 to 2.4), 2.6 (2.6 to 2.6), 3.0 (3.0 to 3.0) and 3.5 (3.4 to 3.5), respectively (p<0.001).

The relative increase in admission rates per 5 increase in BMI was 1.12 (1.12 to 1.13). This relationship did not vary materially by age. Corresponding average durations of stay (in days) per hospital visit within the same categories of BMI were: 3.1 (3.1 to 3.2), 2.8 (2.7 to 2.8), 2.9 (2.9 to 2.9), 3.2 (3.1 to 3.2) and 3.8 (3.7 to 3.8), respectively (P <0.001).

For each of 25 common categories of hospital admission, the most common reason for admission was cataracts with 51,750 admissions; other common reasons for admission were gallbladder disease (35,058), breast cancer (34,307) and ischaemic heart disease (32,483). All but three of the 25 categories of admission considered showed clear associations with BMI, although the magnitudes, and sometimes the shape, of the associations varied considerably.

Most types of hospital admission showed a steady increase in risk across successive categories of BMI from <22.5-35. Women with a BMI of 35 were at least 11 times more likely to be admitted with diabetes than women in the reference group and were also at a substantially increased risk of admission with knee replacement (RR = 7.45, 7.21 to 7.71), venous thromboembolism (RR = 3.05, 2.87 to 3.23), atrial fibrillation (RR = 2.90, 2.74 to 3.07), gallbladder disease (RR = 2.39, 2.30 to 2.47), carpal tunnel syndrome (RR = 2.44, 2.34 to 2.54) and hip replacement (RR = 2.05, 1.96 to 2.15), compared with women in the reference category.

“Clearly, the contribution of overweight and obesity to hospital stays across the entire UK population is likely to be considerably larger,” the authors conclude. “These findings demonstrate that current levels of overweight and obesity among women in the UK are making a substantial contribution to the burden of disease and hospitalisation.”

To access the paper, please click here

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