Relationship between Body Mass Index and Outcomes among Hospitalized Patients with Community-Acquired Pneumonia

Anna M. Bramley*, Carrie Reed, Lyn Finelli, Wesley H. Self, Krow Ampofo, Sandra R. Arnold, Derek J. Williams, Carlos G. Grijalva, Evan J. Anderson, Chris Stockmann, Christopher Trabue, Sherene Fakhran, Robert Balk, Jonathan A. McCullers, Andrew T. Pavia, Kathryn M. Edwards, Richard G. Wunderink, Seema Jain

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background. The effect of body mass index (BMI) on community-acquired pneumonia (CAP) severity is unclear. Methods. We investigated the relationship between BMI and CAP outcomes (hospital length of stay [LOS], intensive care unit [ICU] admission, and invasive mechanical ventilation) in hospitalized CAP patients from the Centers for Disease Control and Prevention Etiology of Pneumonia in the Community (EPIC) study, adjusting for age, demographics, underlying conditions, and smoking status (adults only). Results. Compared with normal-weight children, odds of ICU admission were higher in children who were overweight (adjusted odds ratio [aOR], 1.7; 95% confidence interval [CI], 1.1-2.8) or obese (aOR, 2.1; 95% CI, 1.4-3.2), and odds of mechanical ventilation were higher in children with obesity (aOR, 2.7; 95% CI, 1.3-5.6). When stratified by asthma (presence/absence), these findings remained significant only in children with asthma. Compared with normal-weight adults, odds of LOS >3 days were higher in adults who were underweight (aOR, 1.6; 95% CI, 1.1-2.4), and odds of mechanical ventilation were lowest in adults who were overweight (aOR, 0.5; 95% CI,.3-.9). Conclusions. Children who were overweight or obese, particularly those with asthma, had higher odds of ICU admission or mechanical ventilation. In contrast, adults who were underweight had longer LOS. These results underscore the complex relationship between BMI and CAP outcomes.

Original languageEnglish (US)
Pages (from-to)1873-1882
Number of pages10
JournalJournal of Infectious Diseases
Issue number12
StatePublished - Jun 15 2017


  • BMI
  • CAP
  • obesity
  • outcomes.
  • pneumonia

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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