학술논문

Rates, Variability, and Predictors of Screening for Obesity: Are Individuals with Spinal Cord Injury Being Overlooked?
Document Type
article
Source
Obesity Facts (2022)
Subject
Nutrition. Foods and food supply
TX341-641
Nutritional diseases. Deficiency diseases
RC620-627
Language
English
ISSN
1662-4025
1662-4033
Abstract
Introduction: Individuals with spinal cord injury (SCI) are vulnerable to obesity. Annual obesity screening using body mass index (BMI) is standard of care mandated by U.S. Veterans Health Administration (VHA) guidelines. Our objective is to determine the rates, variability, and predictors of guideline-concordant annual screening for obesity, given potential challenges of height and weight measurements in individuals with SCI. Methods: This is a cross-sectional retrospective study using U.S. national VA databases. We identified all VHA patients with chronic SCI in fiscal year (FY) 2019, their treating facility, and frequency of recorded height and weight. We applied mixed-effects logistic regression models to assess associations between annual obesity screening and patient- and facility-level characteristics. Results: Of 20,978 individuals with chronic SCI in VHA in FY19, guideline-concordant annual BMI-screening was lacking in 37.9%. Accounting for facility level factors (geographic region, SCI facility type, volume of patients with SCI treated at the facility) a mixed-effects logistic regression model demonstrated that lack of annual obesity screening was significantly associated with older patient age (p