The Obesity Paradox in Real-World Nation-Wide Cohort of Patients Admitted for a Stroke in the U.S.
Background: Obesity has been associated with increased incidence and severity of various cardiovascular risk factors and increased risk for stroke. However, the evidence of its effect on outcomes in stroke victims have been equivocal. We aimed to investigate the distribution of BMI in a nation-wide...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/6/1678 |
| _version_ | 1797470494825381888 |
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| author | Guy Rozen Gabby Elbaz-Greener Gilad Margolis Ibrahim Marai Edwin K. Heist Jeremy N. Ruskin Shemy Carasso Ariel Roguin Edo Y. Birati Offer Amir |
| author_facet | Guy Rozen Gabby Elbaz-Greener Gilad Margolis Ibrahim Marai Edwin K. Heist Jeremy N. Ruskin Shemy Carasso Ariel Roguin Edo Y. Birati Offer Amir |
| author_sort | Guy Rozen |
| collection | DOAJ |
| description | Background: Obesity has been associated with increased incidence and severity of various cardiovascular risk factors and increased risk for stroke. However, the evidence of its effect on outcomes in stroke victims have been equivocal. We aimed to investigate the distribution of BMI in a nation-wide cohort of individuals, admitted for a stroke, and the relationship between BMI and in-hospital mortality. Methods: Data from the U.S. National Inpatient Sample (NIS) was collected, to identify hospitalizations for stroke, between October 2015 and December 2016. The patients were sub-divided into six groups based on their BMI: underweight, normal weight, overweight, obese I, obese II and extremely obese groups. Various sociodemographic and clinical parameters were gathered, and incidence of mortality and the length of hospital stay were analyzed. Multivariable analysis was performed to identify independent predictors of in-hospital mortality. Results: A weighted total of 84,185 hospitalizations for stroke were included in the analysis. The approximate mean patients aged was 65.5 ± 31 years, the majority being female (55.3%) and white (63.1%). The overall in-hospital mortality during the study period was 3.6%. A reverse J-shaped relationship between the body mass index and in-hospital mortality was documented, while patients with elevated BMI showed significantly lower in-hospital mortality compared to the underweight and normal weight study participants, 2.8% vs. 7.4%, respectively, <i>p</i> < 0.001. Age and several comorbidities, as well as the Deyo Comorbidity Index, were found to predict mortality in a multivariable analysis. Conclusion: A reverse J-shaped relationship between body mass index and in-hospital mortality was documented in patients admitted for a stroke in the U.S. during the study period. The above findings support the existence of an “obesity paradox” in patients hospitalized following a stroke, similar to that described in other cardiovascular conditions. |
| first_indexed | 2024-03-09T19:38:02Z |
| format | Article |
| id | doaj.art-efc6111c1b254137a2d66385771262bb |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T19:38:02Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-efc6111c1b254137a2d66385771262bb2023-11-24T01:50:41ZengMDPI AGJournal of Clinical Medicine2077-03832022-03-01116167810.3390/jcm11061678The Obesity Paradox in Real-World Nation-Wide Cohort of Patients Admitted for a Stroke in the U.S.Guy Rozen0Gabby Elbaz-Greener1Gilad Margolis2Ibrahim Marai3Edwin K. Heist4Jeremy N. Ruskin5Shemy Carasso6Ariel Roguin7Edo Y. Birati8Offer Amir9Division of Cardiovascular Medicine, Hillel Yaffe Medical Center, Hadera 38100, IsraelDepartment of Cardiology, Hadassah Medical Center, Jerusalem 9574401, IsraelDivision of Cardiovascular Medicine, Hillel Yaffe Medical Center, Hadera 38100, IsraelThe Lydia and Carol Kittner, Lea and Benjamin Davidai Division of Cardiovascular Medicine and Surgery, Baruch Padeh Medical Center, Poriya 1528001, IsraelCardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA 02114, USACardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA 02114, USAThe Lydia and Carol Kittner, Lea and Benjamin Davidai Division of Cardiovascular Medicine and Surgery, Baruch Padeh Medical Center, Poriya 1528001, IsraelDivision of Cardiovascular Medicine, Hillel Yaffe Medical Center, Hadera 38100, IsraelThe Lydia and Carol Kittner, Lea and Benjamin Davidai Division of Cardiovascular Medicine and Surgery, Baruch Padeh Medical Center, Poriya 1528001, IsraelDepartment of Cardiology, Hadassah Medical Center, Jerusalem 9574401, IsraelBackground: Obesity has been associated with increased incidence and severity of various cardiovascular risk factors and increased risk for stroke. However, the evidence of its effect on outcomes in stroke victims have been equivocal. We aimed to investigate the distribution of BMI in a nation-wide cohort of individuals, admitted for a stroke, and the relationship between BMI and in-hospital mortality. Methods: Data from the U.S. National Inpatient Sample (NIS) was collected, to identify hospitalizations for stroke, between October 2015 and December 2016. The patients were sub-divided into six groups based on their BMI: underweight, normal weight, overweight, obese I, obese II and extremely obese groups. Various sociodemographic and clinical parameters were gathered, and incidence of mortality and the length of hospital stay were analyzed. Multivariable analysis was performed to identify independent predictors of in-hospital mortality. Results: A weighted total of 84,185 hospitalizations for stroke were included in the analysis. The approximate mean patients aged was 65.5 ± 31 years, the majority being female (55.3%) and white (63.1%). The overall in-hospital mortality during the study period was 3.6%. A reverse J-shaped relationship between the body mass index and in-hospital mortality was documented, while patients with elevated BMI showed significantly lower in-hospital mortality compared to the underweight and normal weight study participants, 2.8% vs. 7.4%, respectively, <i>p</i> < 0.001. Age and several comorbidities, as well as the Deyo Comorbidity Index, were found to predict mortality in a multivariable analysis. Conclusion: A reverse J-shaped relationship between body mass index and in-hospital mortality was documented in patients admitted for a stroke in the U.S. during the study period. The above findings support the existence of an “obesity paradox” in patients hospitalized following a stroke, similar to that described in other cardiovascular conditions.https://www.mdpi.com/2077-0383/11/6/1678body mass indexBMIsudden cardiac deathobesity paradox |
| spellingShingle | Guy Rozen Gabby Elbaz-Greener Gilad Margolis Ibrahim Marai Edwin K. Heist Jeremy N. Ruskin Shemy Carasso Ariel Roguin Edo Y. Birati Offer Amir The Obesity Paradox in Real-World Nation-Wide Cohort of Patients Admitted for a Stroke in the U.S. Journal of Clinical Medicine body mass index BMI sudden cardiac death obesity paradox |
| title | The Obesity Paradox in Real-World Nation-Wide Cohort of Patients Admitted for a Stroke in the U.S. |
| title_full | The Obesity Paradox in Real-World Nation-Wide Cohort of Patients Admitted for a Stroke in the U.S. |
| title_fullStr | The Obesity Paradox in Real-World Nation-Wide Cohort of Patients Admitted for a Stroke in the U.S. |
| title_full_unstemmed | The Obesity Paradox in Real-World Nation-Wide Cohort of Patients Admitted for a Stroke in the U.S. |
| title_short | The Obesity Paradox in Real-World Nation-Wide Cohort of Patients Admitted for a Stroke in the U.S. |
| title_sort | obesity paradox in real world nation wide cohort of patients admitted for a stroke in the u s |
| topic | body mass index BMI sudden cardiac death obesity paradox |
| url | https://www.mdpi.com/2077-0383/11/6/1678 |
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