Ron Goldberg 

Patients with asthma and obesity had longer hospitalizations, higher care costs, and a more near-fatal asthma events than those without obesity.

An increased risk for near-fatal asthma events may exist among patients with asthma and comorbid obesity, according to review findings presented at the American Academy of Allergy, Asthma and Immunology (AAAAI) 2023 Annual Meeting, held in San Antonio, Texas, February 24 to 27.

Investigators sought to ascertain whether obesity is a risk factor for a fatal or near-fatal asthma event among US patients with an exacerbation. They defined near-fatal as an asthma exacerbation resulting in tracheostomy, cardiac arrest, and/or respiratory arrest.

In this retrospective review, investigators used the National Inpatient Sample from 2005 to 2014 and ICD-9 codes to identify 677,591 cases of asthma exacerbation in patients at least 5 years of age. Among all patients (mean [SD] age 47.8 [23.8] years; 66% female; 52% White; 86% non-Hispanic) the investigators noted 125,095 (18%) cases with obesity, 936 (0.14%) near-fatal asthma events, and 2538 (0.37%) all-cause fatal events.Asthma patients with obesity had an increased risk for near-fatal asthma events with a longer hospital length of stay and cost compared to non-obese asthma patients.

Among the patients with obesity, the investigators found increased mean hospital length of stay (4.2 vs 3.5 days; P <.0001), greater care costs ($24,550 vs $18,973; P <.0001), and a greater incidence of near-fatal asthma events (0.2% vs 0.1%; P <.02) than among patients without obesity.

The researchers concluded that “Asthma patients with obesity had an increased risk for near-fatal asthma events with a longer hospital length of stay and cost compared to non-obese asthma patients.” Further study is needed to identify underlying mechanisms of increased risk, the investigators added.

References:

Mueller K, Rank M, Gonzalez-Estrada A, Cardenas-Rosales J, Chiarella S. Obesity is a risk factor for worse asthma exacerbation outcomes in the United States. J Allergy Clin Immunol. 2023; 151(2):AB72. doi:10.1016/j.jaci.2022.12.227