期刊
ANNALS OF MEDICINE AND SURGERY
卷 70, 期 -, 页码 -出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.amsu.2021.102839
关键词
Ischemic stroke; Hemorrhagic stroke; Body mass index; In-hospital mortality; Obesity paradox
This study found that obese patients are less likely to die during hospitalization following first-time non-subarachnoid hemorrhage and ischemic stroke compared to non-overweight/non-obese patients.
Background: While it is widely held that obesity is a risk factor for stroke, its role in mortality after stroke is less understood. We aim to examine effects of Body Mass Index (BMI) on in-hospital mortality after non-subarachnoid, subarachnoid, and ischemic stroke. Methods: Retrospective cohort study. Patients aged >= 18 years, who were hospitalized in Florida hospitals between 2008 and 2012 with a diagnosis of first-time stroke as reported by the Agency for Health Care Administration (AHCA). The main independent variable was BMI category, which was divided into non-overweight/non-obese, obese, and morbidly obese. The primary outcome was the adjusted odds ratio (aOR) for in-hospital mortality for subarachnoid and non-subarachnoid hemorrhagic stroke, and ischemic stroke. Logistic regression modeling was utilized to examine the association between each BMI category and in-hospital mortality, while controlling for several potential confounders. This study was reported in line with the STROCSS criteria. Results: Of the 333,367 patients included in the database, 150,153 (45.0%) patients met inclusion criteria. After adjusting for age, gender, ethnicity and other possible confounders, obese patients were 21% less likely to die during their hospitalization following a first ischemic stroke (0.79 aOR, 0.69-0.92, 95% CI, p = 0.002), and 32% less likely following a first non-subarachnoid hemorrhage (0.68 aOR, 0.57-0.82, 95% CI, p = 0.0001) compared to non-overweight/non-obese counterparts. Conclusion: Obese patients are less likely to die during hospitalization following first-time non-subarachnoid hemorrhage and ischemic stroke than non-overweight/non-obese patients. These findings support the obesity paradox concept, though more research is needed for recurrent stroke patients.
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