 Home > Active Ingredient News > Study of Nervous System > J Clin Med: The obesity paradox in stroke hospitalized patients in a real-world study

J Clin Med: The obesity paradox in stroke hospitalized patients in a real-world study

 Last Update: 2022-04-24
 Source: Internet
 Author: User

Tags

hospital bed table sale

cholesterol egg white

Search more information of high quality chemicals, good prices and reliable suppliers, visit www.echemi.com

Both obesity and stroke have reached epidemic proportions and are clearly related
.

According to recent data, up to 25% of adults over the age of 25 are expected to experience a stroke in their lifetime

Both obesity and stroke have reached epidemic proportions and are clearly related

Many studies link obesity with higher morbidity and increased severity of several cardiovascular risk factors, including an increased risk of stroke

The data were collected from the National Inpatient Sample (NIS), the Healthcare Cost and Utilization Project (HCUP), and the Agency for Healthcare Research and Quality (AHRQ)

For this study, we collected data on hospitalizations in the United States between October 2015 and December 2016

Investigators divided BMI into 6 subgroups, including BMI ≤ 19 kg/m ²as underweight; BMI 20–25 kg/m ², normal weight; BMI 26–30 kg/m ², overweight; BMI 31–35 kg/m ², obese group I; BMI 36–39 kg/m ², obese group II; BMI ≥40 kg/m ², super obese group

A total of 16,837 hospitalizations for stroke in the United States were included in the analysis

In terms of clinical characteristics, 38% had a history of diabetes mellitus , 67% had essential hypertension , 10% had peripheral vascular disease, and 23% had a history of atrial fibrillation or flutter

Of the total population hospitalized for stroke, 8.

In-hospital mortality was recorded at 3.
6% in stroke hospitalized patients
.

Figure 2 shows the association between BMI and in-hospital mortality in the study population

In-hospital mortality was recorded at 3.

Several parameters were found to significantly increase the odds of in-hospital mortality in unadjusted analyses (Table 2)
.

These included: age, whiteness, personal history of hypertension, renal failure, peripheral vascular disease, heart failure, and atrial fibrillation/flutter (all p < 0.

Several parameters were found to significantly increase the odds of in-hospital mortality in unadjusted analyses (Table 2)

After adjusting for potential confounders, most of the above (except peripheral vascular disease) remained independent predictors of in-hospital mortality in multivariate analysis (Table 3)
.
Higher BMI and diabetes were independent predictors of improved survival
.
Deyo comorbidity index ≥2 was also an independent predictor of mortality in hospitalized stroke patients, OR-2.
39 (1.
94-2.
94), p < 0.
001
.
After adjusting for potential confounders, most of the above (except peripheral vascular disease) remained independent predictors of in-hospital mortality in multivariate analysis (Table 3)
.
Higher BMI and diabetes were independent predictors of improved survival
.
Deyo comorbidity index ≥2 was also an independent predictor of mortality in hospitalized stroke patients, OR-2.
39 (1.
94-2.
94), p < 0.
001
.

Multivariable Analysis for Predictors of In-Hospital Mortality.

Predictor	Probability (95% CI)	Odds Ratio (95% CI)	p -Value
Age Group, years			<0. 001
18–44 years	1. 41% (1. 14, 1. 74)	1. 00 (reference)	n/A
45–59 years	1. 32% (1. 14, 1. 53)	0. 93 (0. 76, 1. 15)	0. 514
60–74 years	1. 95% (1. 71, 2. 21)	1. 39 (1. 14, 1. 69)	0. 001
≥75 years	2. 67% (2. 35, 3. 04)	1. 92 (1. 57, 2. 35)	<0. 001
Gender			0. 023
Male	1. 85% (1. 62, 2. 10)	1. 00 (reference)	n/A
Female	1. 69% (1. 48, 1. 92)	0. 91 (0. 84, 0. 99)	0. 023
Race			<0. 001
Non-white	1. 63% (1. 42, 1. 87)	1. 00 (reference)	n/A
White	1. 91% (1. 69, 2. 16)	1. 18 (1. 08, 1. 29)	<0. 001
BMI Group			<0. 001
20–25	2. 55% (2. 17, 3. 00)	1. 00 (reference)	n/A
Below 20	3. 85% (3. 35, 4. 43)	1. 53 (1. 34, 1. 75)	<0. 001
26–30	1. 44% (1. 23, 1. 69)	0. 56 (0. 48, 0. 65)	<0. 001
31–35	1. 14% (0. 98, 1. 32)	0. 44 (0. 38, 0. 51)	<0. 001
36–39	1. 07% (0. 90, 1. 26)	0. 41 (0. 35, 0. 49)	<0. 001
40 and Above	1. 73% (1. 51, 1. 99)	0. 67 (0. 58, 0. 78)	<0. 001
Atrial Fibrillation/Flutter			<0. 001
No	1. 58% (1. 39, 1. 79)	1. 00 (reference)	n/A
Yes	2. 91% (2. 53, 3. 33)	1. 86 (1. 71, 2. 02)	<0. 001
Congestive heart failure			<0. 001
No	1. 73% (1. 53, 1. 96)	1. 00 (reference)	n/A
Yes	2. 20% (1. 90, 2. 56)	1. 28 (1. 16, 1. 41)	<0. 001
Chronic pulmonary disease			0. 002
No	1. 75% (1. 54, 1. 98)	1. 00 (reference)	n/A
Yes	2. 00% (1. 73, 2. 32)	1. 15 (1. 05, 1. 26)	0. 002
Diabetes Mellitus			<0. 001
No	1. 84% (1. 63, 2. 08)	1. 00 (reference)	n/A
Yes	1. 40% (1. 21, 1. 62)	0. 76 (0. 69, 0. 83)	<0. 001
Hypertension			<0. 001
No	2. 27% (1. 99, 2. 59)	1. 00 (reference)	n/A
Yes	1. 53% (1. 34, 1. 73)	0. 67 (0. 62, 0. 72)	<0. 001
Obesity			<0. 001
No	3. 15% (2. 76, 3. 61)	1. 00 (reference)	n/A
Yes	1. 11% (0. 96, 1. 27)	0. 34 (0. 31, 0. 39)	<0. 001
Peripheral vascular disorders			0. 392
No	1. 76% (1. 56, 1. 99)	1. 00 (reference)	n/A
Yes	1. 85% (1. 57, 2. 18)	1. 05 (0. 94, 1. 18)	0. 392
Renal failure			<0. 001
No	1. 71% (1. 51, 1. 93)	1. 00 (reference)	n/A
Yes	2. 32% (2. 01, 2. 68)	1. 37 (1. 25, 1. 49)	<0. 001
Income Percentile			0. 011
0 to 25th percentile	1. 86% (1. 63, 2. 12)	1. 00 (reference)	n/A
26th to 50th percentile	1. 86% (1. 62, 2. 13)	1. 00 (0. 90, 1. 11)	0. 995
51st to 75th percentile	1. 81% (1. 57, 2. 09)	0. 97 (0. 88, 1. 08)	0. 608
76th to 100th percentile	1. 55% (1. 33, 1. 81)	0. 83 (0. 74, 0. 94)	0. 002
Deyo-CCI			<0. 001
1	1. 15% (0. 93, 1. 42)	1. 00 (reference)	n/A
2 or higher	2. 70% (2. 48, 2. 93)	2. 39 (1. 94, 2. 94)	<0. 001

Predictor Probability (95% CI) Odds Ratio (95% CI) p -Value Predictor Probability (95% CI) Odds Ratio (95% CI) p -Value PredictorProbability (95% CI)Odds Ratio (95% CI) p -Value p Age Group, years <0.
001 18–44 years 1.
41% (1.
14, 1.
74) 1.
00 (reference) n/A 45–59 years 1.
32% (1.
14, 1.
53) 0.
93 (0.
76, 1.
15) 0.
514 60–74 years 1.
95% (1.
71 , 2.
21) 1.
39 (1.
14, 1.
69) 0.
001 ≥75 years 2.
67% (2.
35, 3.
04) 1.
92 (1.
57, 2.
35) <0.
001 Gender 0.
023 Male 1.
85% (1.
62, 2.
10) 1.
00 (reference) n/A Female 1.
69% (1.
48 , 1.
92) 0.
91 (0.
84, 0.
99) 0.
023 Race <0.
001 Non-white 1.
63% (1.
42, 1.
87) 1.
00 (reference) n/A White 1.
91% (1.
69, 2.
16) 1.
18 (1.
08, 1.
29) <0.
001 BMI Group <0.
001 20–25 2.
55% (2.
17, 3.
00) 1.
00 (reference) n/A Below 20 3.
85% (3.
35, 4.
43) 1.
53 (1.
34, 1.
75) <0.
001 26–30 1.
44% (1.
23, 1.
69) 0.
56 (0.
48, 0.
65) <0.
001 31–35 1.
14% (0.
98, 1.
32) 0.
44 (0.
38, 0.
51) <0.
001 36–39 1.
07% (0.
90, 1.
26) 0.
41 (0.
35, 0.
49) <0.
001 40 and Above 1.
73% (1.
51, 1.
99) 0.
67 (1.
99) 0.
58, 0.
78) <0.
001 Atrial Fibrillation/Flutter <0.
001 No 1.
58% (1.
39, 1.
79) 1.
00 (reference) n/A Yes 2.
91% (2.
53, 3.
33) 1.
86 (1.
71, 2.
02) <0.
001 Congestive heart failure <0.
001 No 1.
73 % (1.
53, 1.
96) 1.
00 (reference) n/A Yes 2.
20% (1.
90, 2.
56) 1.
28 (1.
16, 1.
41) <0.
001 Chronic pulmonary disease 0.
002 No 1.
75% (1.
54, 1.
98) 1.
00 (reference) n/A Yes 2.
00 Hypertension < 0.
001 No 2.
27% (1.
99, 2.
59) 1.
00 (reference) n/A Yes 1.
53% (1.
34, 1.
73) 0.
67 (0.
62, 0.
72) <0.
001 Obesity <0.
001 No 3.
15% (2.
76, 3.
61) 1.
00 (reference) n/A Yes 1.
11% (0.
96, 1.
27) 0.
34 (0.
31, 0.
39) <0.
001 Peripheral vascular disorders 0.
392 No 1.
76% (1.
56, 1.
99) 1.
00 (reference) n/A Yes 1.
85% (1.
57, 2.
18) 1.
05 (0.
94, 1.
18) 0.
392 Renal failure <0.
001 No 1.
71% (1.
51, 1.
93) 1.
00 (reference ) n/A Yes 2.
32% (2.
01, 2.
68) 1.
37 (1.
25, 1.
49) <0.
001 Income Percentile 0.
011 0 to 25th percentile 1.
86% (1.
63, 2.
12) 1.
00 (reference) n/A 26th to 50th percentile 1.
86% (1.
62, 2.
13) 1.
00 (0.
90, 1.
11) 0.
995 51st to 75th percentile 1.
81% (1.
57, 2.
09) 0.
97 (0.
88, 1.
08) 0.
608 76th to 100th percentile 1.
55% (1.
33, 1.
81) 0.
83 (0.
710, 0.
94) 1 1.
15% (0.
93, 1.
42) 1.
00 (reference) n/A 2 or higher 2.
70% (2.
48, 2.
93) 2.
39 (1.
94, 2.
94) <0.
001 Age Group, years <0.
001 Age Group, years <0.
001 18–44 years 1.
41 % (1.
14, 1.
74) 1.
00 (reference) n/A 18–44 years1.
41% (1.
14, 1.
74)1.
00 (reference)n/A 45–59 years 1.
32% (1.
14, 1.
53) 0.
93 (0.
76, 1.
15) 0.
514 45–59 years1.
32% (1.
14, 1.
53)0.
93 (0.
76, 1.
15)0.
514 60–74 years 1.
95% (1.
71, 2.
21) 1.
39 (1.
14, 1.
69) 0.
001 60–74 years1.
95% (1.
71, 2.
21)1.
39 (1.
14, 1.
69)0.
001 ≥75 years 2.
67% (2.
35, 3.
04) 1.
92 (1.
57, ≥2.
35) <0.
001 75 years2.
67% (2.
35, 3.
04)1.
92 (1.
57, 2.
35)<0.
001 Gender 0.
023 Gender 0.
023 Male 1.
85% (1.
62, 2.
10) 1.
00 (reference) n/A Male1.
85% (1.
62, 2.
10)1.
00 (reference) n/A Female 1.
69% (1.
48, 1.
92) 0.
91 (0.
84, 0.
99) 0.
023 Female1.
69% (1.
48, 1.
92)0.
91 (0.
84, 0.
99)0.
023 Race <0.
001 Race <0.
001 Non-white 1.
63% (1.
42, 1.
87) 1.
00 (reference) n/A Non-white1.
63% (1.
42, 1.
87)1.
00 (reference)n/A White 1.
91% (1.
69, 2.
16) 1.
18 (1.
08, 1.
29) <0.
001 White1.
91% (1.
69, 2.
16) 1.
18 (1.
08, 1.
29)<0.
001 BMI Group <0.
001 BMI Group <0.
001 20–25 2.
55% (2.
17, 3.
00) 1.
00 (reference) n/A 20–252.
55% (2.
17, 3.
00)1.
00 (reference)n/A Below 20 3.
85% (3.
35, 4.
43) 1.
53 (1.
34, 1.
75) < 0.
001 Below 203.
85% (3.
35, 4.
43)1.
53 (1.
34, 1.
75)<0.
001 26–30 1.
44% (1.
23, 1.
69) 0.
56 (0.
48, 0.
65) <0.
001 26–301.
44% (1.
23, 1.
69, 0.
56) (0.
44) <0.
001 31–35 1.
14% (0.
98, 1.
32) 0.
44 (0.
38, 0.
51) <0.
001 31–351.
14% (0.
98, 1.
32)0.
44 (0.
38, 0.
51)<0.
001 36–39 1.
07% (0.
90, 1.
26) 0.
4 , 0.
49) <0.
001 36–391.
07% (0.
90, 1.
26)0.
41 (0.
35, 0.
49)<0.
001 40 and Above 1.
73% (1.
51, 1.
99) 0.
67 (0.
58, 0.
78) <0.
001 40 and Above1.
73% (1.
51, 1.
99 )0.
67 (0.
58, 0.
78)<0.
001 Atrial Fibrillation/Flutter <0.
001 Atrial Fibrillation/Flutter <0.
001 No 1.
58% (1.
39, 1.
79) 1.
00 (reference) n/A No1.
58% (1.
39, 1.
79)1.
00 (reference)n /A Yes 2.
91% (2.
53, 3.
33) 1.
86 (1.
71, 2.
02) <0.
001 Yes2.
91% (2.
53, 3.
33)1.
86 (1.
71, 2.
02)<0.
001 Congestive heart failure <0.
001 Congestive heart failure <0.
001 No 1.
73% (1.
53, 1.
96) 1.
00 (reference) n/A No1.
73% (1.
53, 1.
96)1.
00 (reference)n/A Yes 2.
20% (1.
90, 2.
56) 1.
28 (1.
16, 1.
41) <0.
001 Yes2.
20% (1.
90, 2.
56)1.
28 (1.
16, 1.
41)<0.
001 Chronic pulmonary disease 0.
002 Chronic pulmonary disease 0.
002 No 1.
75% (1.
54, 1.
98) 1.
00 (reference) n/A No1.
75% (1.
54, 1.
98)1.
00 (reference)n/A Yes 2.
00% (1.
73, 2.
32) 1.
15 (1.
05, 1.
26) 0.
002 Yes2.
00% (1.
73, 2.
32)1.
15 (1.
05, 1.
26)0.
002 Diabetes Mellitus <0.
001 Diabetes Mellitus <0.
001 No 1.
84% (1.
63, 2.
08) 1.
00 (reference) n/A No1.
84% (1.
63, 2.
08)1.
00 (reference)n/ A Yes 1.
40% (1.
21, 1.
62) 0.
76 (0.
69, 0.
83) <0.
001 Yes1.
40% (1.
21, 1.
62)0.
76 (0.
69, 0.
83)<0.
001 Hypertension <0.
001 Hypertension <0.
001 No 2.
27% (1.
99, 2.
59) 1.
00 (reference) n/A No2.
27% (1.
99, 2.
59)1.
00 (reference)n/A Yes 1.
53% (1.
34, 1.
73) 0.
67 (0.
62, 0.
72) <0.
001 Yes1.
53% (1.
34, 1.
73)0.
67 (0.
62, 0.
72)<0.
001 Obesity <0.
001 Obesity <0.
001 No 3.
15% (2.
76, 3.
61) 1.
00 (reference) n/A No3.
15% (2.
76, 3.
61)1.
00 (reference)n /A Yes 1.
11% (0.
96, 1.
27) 0.
34 (0.
31, 0.
39) <0.
001 Yes1.
11% (0.
96, 1.
27)0.
34 (0.
31, 0.
39)<0.
001 Peripheral vascular disorders 0.
392 Peripheral vascular disorders 0.
392 No 1.
76% (1.
56, 1.
999) ) 1.
00 (reference) n/A No1.
76% (1.
56, 1.
99)1.
00 (reference)n/A Yes 1.
85% (1.
57, 2.
18) 1.
05 (0.
94, 1.
18) 0.
392 Yes1.
85% (1.
57, 2.
18)1.
05 ( 0.
94, 1.
18)0.
392 Renal failure <0.
001 Renal failure <0.
001 No 1.
71% (1.
51, 1.
93) 1.
00 (reference) n/A No1.
71% (1.
51, 1.
93)1.
00 (reference)n/A Yes 2.
32% (2.
01, 2.
68) 1.
37 (1.
25, 1.
49) <0.
001 Yes2.
32% (2.
01, 2.
68)1.
37 (1.
25, 1.
49)<0.
001 Income Percentile 0.
011 Income Percentile 0.
011 0 to 25th percentile 1.
86% (1.
63, 2.
12) 1.
00 (reference) n/A 0 to 25th percentile1.
86% ( 1.
63, 2.
12)1.
00 (reference)n/A 26th to 50th percentile 1.
86% (1.
62, 2.
13) 1.
00 (0.
90, 1.
11) 0.
995 26th to 50th percentile1.
86% (1.
62, 2.
13)1.
00 (0.
90, 1.
11)0.
995 51 75th percentile 1.
81% (1.
57, 2.
09) 0.
97 (0.
88, 1.
08) 0.
608 51st to 75th percentile1.
81% (1.
57, 2.
09)0.
97 (0.
88, 1.
08)0.
608 0.
94) 0.
002 76th to 100th percentile1.
55% (1.
33, 1.
81)0.
83 (0.
74, 0.
94)0.
002 Deyo-CCI <0.
001 Deyo-CCI <0.
001 1 1.
15% (0.
93, 1.
42) 1.
00 (reference) n/A 11.
15% ( 0.
93, 1.
42)1.
00 (reference)n/A 2 or higher 2.
70% (2.
48, 2.
93) 2.
39 (1.
94, 2.
94) <0.
001 2 or higher2.
70% (2.
48, 2.
93)2.
39 (1.
94, 2.
94)<0.
001

。，，，
。 NIS ， 30
。，
。“”
。 NIS ，、、
。，
。，，
。

。，，，
。 NIS ， 30
。，
。“”
。 NIS ，、、
。，
。，，
。
。，，，
。 NIS ， 30
。，
。“”
。 NIS ，、、
。，
。，，
。

，， J
。“”，
。

，， J
。“”，
。，， J
。“”，
。

：

：：

Rozen G, Elbaz-Greener G, Margolis G, Marai I, Heist EK, Ruskin JN, Carasso S, Roguin A, Birati EY, Amir O.
The Obesity Paradox in Real-World Nation-Wide Cohort of Patients Admitted for a Stroke in the U.
S.
J Clin Med.
2022 Mar 17;11(6):1678.
doi: 10.
3390/jcm11061678

Rozen G, Elbaz-Greener G, Margolis G, Marai I, Heist EK, Ruskin JN, Carasso S, Roguin A, Birati EY, Amir O.
The Obesity Paradox in Real-World Nation-Wide Cohort of Patients Admitted for a Stroke in the US The Obesity Paradox in Real-World Nation-Wide Cohort of Patients Admitted for a Stroke in the US Leave a Comment

This article is an English version of an article which is originally in the Chinese language on echemi.com and is provided for information purposes only. This website makes no representation or warranty of any kind, either expressed or implied, as to the accuracy, completeness ownership or reliability of the article or any translations thereof. If you have any concerns or complaints relating to the article, please send an email, providing a detailed description of the concern or complaint, to service@echemi.com. A staff member will contact you within 5 working days. Once verified, infringing content will be removed immediately.