(269) Impact of Obesity on Clinical and Economic Outcomes in Hospitalized Patients with Skin and Subcutaneous Tissue Infections Receiving Systemic Antibacterial Therapy in Korea

Background: The global increase in obesity prevalence is worrisome as obesity can heighten susceptibility to bacterial infections and exacerbate the severity of infectious diseases. Despite this understanding, there remains a scarcity of research using real-world evidence, such as largescale healthcare data, to examine the impact of obesity on clinical and economic outcomes in patients with skin and subcutaneous tissue infections (SSTIs).

Objectives: This study aims to assess the influence of obesity on clinical and economic outcomes in hospitalized patients receiving systemic antibacterial therapy for SSTIs in South Korea.

Methods: We conducted a retrospective cohort study using Korea’s National Health Insurance claims data, encompassing 53,655 adult patients hospitalized with SSTIs in 2018, who received systemic antibacterial treatment and had body mass index (BMI) and waist circumference data available from health examinations. Patient outcomes, including hospital length of stays and treatment costs, readmissions within a two-year period, and other non-hospitalization associated costs were collected. We evaluated the impact of obesity on readmission using Cox proportional hazard modeling and estimated the attributable costs of readmission through bootstrap techniques using a two-part model.

Results: The predominant antibiotic administered to patients was beta-lactam, excluding penicillin (91.0%). Among male patients, hospitalization stays and costs decreased with increasing BMI, with no discernible difference based on waist circumference. Conversely, in female patients, both hospitalization stays and costs increased as BMI and waist circumference increased. Readmissions within two years due to SSTIs increased as BMI and waist circumference increased in both genders (p < 0.001). Estimated readmission costs were significantly higher in gender-specific comparisons, increasing by 55% among men with a waist circumference of 100 cm or more compared to those with less than 80 cm and by 132% among women with a waist circumference of 95 cm or more compared to those with less than 75 cm.

Conclusions: Obesity significantly impacts the length and cost of hospitalization stays for SSTIs in female patients and increases the probability of readmission and associated readmission costs for both males and females. Improved obesity management is crucial for better clinical and economic outcomes in SSTI treatment.