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Clinical impact of body mass index on outcomes of ischemic and hemorrhagic strokes.
Miwa, Kaori; Nakai, Michikazu; Yoshimura, Sohei; Sasahara, Yusuke; Wada, Shinichi; Koge, Junpei; Ishigami, Akiko; Yagita, Yoshiki; Kamiyama, Kenji; Miyamoto, Yoshihiro; Kobayashi, Shotai; Minematsu, Kazuo; Toyoda, Kazunori; Koga, Masatoshi.
Afiliación
  • Miwa K; Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Nakai M; Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Yoshimura S; Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Sasahara Y; Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Wada S; Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Koge J; Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Ishigami A; Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Yagita Y; Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan.
  • Kamiyama K; Nakamura Memorial Hospital, Sapporo, Japan.
  • Miyamoto Y; Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Kobayashi S; Shimane University School of Medicine, Izumo, Japan.
  • Minematsu K; Medical Corporation ISEIKAI, Osaka, Japan.
  • Toyoda K; Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Koga M; Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Int J Stroke ; 19(8): 907-915, 2024 Oct.
Article en En | MEDLINE | ID: mdl-38651751
ABSTRACT
BACKGROUND AND

AIM:

To investigate the prognostic implication of body mass index (BMI) on clinical outcomes after acute ischemic and hemorrhagic stroke.

METHODS:

The subjects of the study included adult patients with available baseline body weight and height data who had suffered an acute stroke and were registered in the Japan Stroke Data Bank-a hospital-based, multicenter stroke registration database-between January 2006 and December 2020. The outcome measures included unfavorable outcomes defined as a modified Rankin Scale (mRS) score of 5-6 and favorable outcomes (mRS 0-2) at discharge, and in-hospital mortality. Mixed effects logistic regression analysis was conducted to determine the relationship between BMI categories (underweight, normal weight, overweight, class I obesity, class II obesity; <18.5, 18.5-23.0, 23.0-25.0, 25-30, ⩾30 kg/m2) and the outcomes, after adjustment for covariates.

RESULTS:

A total of 56,230 patients were assigned to one of the following groups ischemic stroke (IS, n = 43,668), intracerebral hemorrhage (ICH, n = 9741), and subarachnoid hemorrhage (SAH, n = 2821). In the IS group, being underweight was associated with an increased likelihood of unfavorable outcomes (odds ratio, 1.47 (95% confidence interval (CI)1.31-1.65)) and in-hospital mortality (1.55 (1.31-1.83)) compared to outcomes in those with normal weight. Being overweight was associated with an increased likelihood of favorable outcomes (1.09 (1.01-1.18)). Similar associations were observed between underweight and these outcomes in specific IS subtypes (cardioembolic stroke, large artery stroke, and small-vessel occlusion). Patients with a BMI ⩾30.0 kg/m2 was associated with an increased likelihood of unfavorable outcomes (1.44 (1.01-2.17)) and in-hospital mortality (2.42 (1.26-4.65)) in large artery stroke. In patients with ICH, but not those with SAH, being underweight was associated with an increased likelihood of unfavorable outcomes (1.41 (1.01-1.99)).

CONCLUSIONS:

BMI substantially impacts functional outcomes following IS and ICH. Lower BMI consistently affected post-stroke disability and mortality, while higher BMI values similarly affected these outcomes after large artery stroke.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Índice de Masa Corporal / Mortalidad Hospitalaria / Accidente Cerebrovascular Isquémico / Accidente Cerebrovascular Hemorrágico Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Int J Stroke Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Índice de Masa Corporal / Mortalidad Hospitalaria / Accidente Cerebrovascular Isquémico / Accidente Cerebrovascular Hemorrágico Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Int J Stroke Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos