Overweight-mortality paradox and impact of six-minute walk distance in lung transplantation
Overweight-mortality paradox and impact of six-minute walk distance (SMWD) in lung transplantation Background: The objective of this study was to examine combined prognostic influence of body mass index (BMI) and SMWD on mortality in lung transplant recipients. Methods: Consecutive isolated lung t...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2015-01-01
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| Series: | Annals of Thoracic Medicine |
| Subjects: | |
| Online Access: | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2015;volume=10;issue=3;spage=169;epage=175;aulast=Chaikriangkrai |
| _version_ | 1811331010672984064 |
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| author | Kongkiat Chaikriangkrai Hye Yeon Jhun Edward A Graviss Soma Jyothula |
| author_facet | Kongkiat Chaikriangkrai Hye Yeon Jhun Edward A Graviss Soma Jyothula |
| author_sort | Kongkiat Chaikriangkrai |
| collection | DOAJ |
| description | Overweight-mortality paradox and impact of six-minute walk distance (SMWD) in lung transplantation
Background: The objective of this study was to examine combined prognostic influence of body mass index (BMI) and SMWD on mortality in lung transplant recipients.
Methods: Consecutive isolated lung transplant recipients were identified. Preoperative BMI and SMWD data were collected. The cohort was followed for all-cause mortality.
Results: The study included 324 lung transplant recipients with mean age of 57 ± 13 years and 58% were male (27% obstructive, 3% vascular, 6% cystic fibrosis, and 64% with restrictive lung diseases). In the total cohort; 37% had normal BMI, 10% were underweight, 33% were overweight, and 20% were obese. The median SMWD was 700 feet. The lower SMWDgroup was defined as the patients who had SMWD <237 feet as determined by receiver operating characteristic (ROC). Based on this definition, 66 patients (20%) had lower SMWD. There were 71 deaths during a median follow-up of 2.3 years. In multivariate analysis, both BMI and SMWD were independently associated with death. Being overweight was associated with reduced mortality risk (hazard ratio (HR) 0.50, P = 0.042) compared to the normal BMI group, and this was primarily driven by early mortality posttransplant. This paradoxical overweight-mortality relationship remained significant in the lower SMWD group (HR 0.075, P = 0.018), but not in the higher SMWD group (P = 0.552).
Conclusion: In lung transplant recipients under lung allocation score (LAS) era, pretransplant BMI and SMWD were independent predictors for mortality after the transplant. The lowest mortality risk was noted in a group of transplant recipients identified as overweight; whereas, being underweight or obese was associated with increased mortality. |
| first_indexed | 2024-04-13T16:12:25Z |
| format | Article |
| id | doaj.art-0b0a4e020ea44966af21bc8284cd6ed2 |
| institution | Directory Open Access Journal |
| issn | 1817-1737 1998-3557 |
| language | English |
| last_indexed | 2024-04-13T16:12:25Z |
| publishDate | 2015-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Thoracic Medicine |
| spelling | doaj.art-0b0a4e020ea44966af21bc8284cd6ed22022-12-22T02:40:11ZengWolters Kluwer Medknow PublicationsAnnals of Thoracic Medicine1817-17371998-35572015-01-0110316917510.4103/1817-1737.160835Overweight-mortality paradox and impact of six-minute walk distance in lung transplantationKongkiat ChaikriangkraiHye Yeon JhunEdward A GravissSoma JyothulaOverweight-mortality paradox and impact of six-minute walk distance (SMWD) in lung transplantation Background: The objective of this study was to examine combined prognostic influence of body mass index (BMI) and SMWD on mortality in lung transplant recipients. Methods: Consecutive isolated lung transplant recipients were identified. Preoperative BMI and SMWD data were collected. The cohort was followed for all-cause mortality. Results: The study included 324 lung transplant recipients with mean age of 57 ± 13 years and 58% were male (27% obstructive, 3% vascular, 6% cystic fibrosis, and 64% with restrictive lung diseases). In the total cohort; 37% had normal BMI, 10% were underweight, 33% were overweight, and 20% were obese. The median SMWD was 700 feet. The lower SMWDgroup was defined as the patients who had SMWD <237 feet as determined by receiver operating characteristic (ROC). Based on this definition, 66 patients (20%) had lower SMWD. There were 71 deaths during a median follow-up of 2.3 years. In multivariate analysis, both BMI and SMWD were independently associated with death. Being overweight was associated with reduced mortality risk (hazard ratio (HR) 0.50, P = 0.042) compared to the normal BMI group, and this was primarily driven by early mortality posttransplant. This paradoxical overweight-mortality relationship remained significant in the lower SMWD group (HR 0.075, P = 0.018), but not in the higher SMWD group (P = 0.552). Conclusion: In lung transplant recipients under lung allocation score (LAS) era, pretransplant BMI and SMWD were independent predictors for mortality after the transplant. The lowest mortality risk was noted in a group of transplant recipients identified as overweight; whereas, being underweight or obese was associated with increased mortality.http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2015;volume=10;issue=3;spage=169;epage=175;aulast=ChaikriangkraiBody mass indexbody compositionlung transplantsix-minute walkobesity paradox |
| spellingShingle | Kongkiat Chaikriangkrai Hye Yeon Jhun Edward A Graviss Soma Jyothula Overweight-mortality paradox and impact of six-minute walk distance in lung transplantation Annals of Thoracic Medicine Body mass index body composition lung transplant six-minute walk obesity paradox |
| title | Overweight-mortality paradox and impact of six-minute walk distance in lung transplantation |
| title_full | Overweight-mortality paradox and impact of six-minute walk distance in lung transplantation |
| title_fullStr | Overweight-mortality paradox and impact of six-minute walk distance in lung transplantation |
| title_full_unstemmed | Overweight-mortality paradox and impact of six-minute walk distance in lung transplantation |
| title_short | Overweight-mortality paradox and impact of six-minute walk distance in lung transplantation |
| title_sort | overweight mortality paradox and impact of six minute walk distance in lung transplantation |
| topic | Body mass index body composition lung transplant six-minute walk obesity paradox |
| url | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2015;volume=10;issue=3;spage=169;epage=175;aulast=Chaikriangkrai |
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