scholarly journals The impact of body mass index on the wearable cardioverter defibrillator shock efficacy and patient wear time

2017 ◽  
Vol 186 ◽  
pp. 111-117 ◽  
Author(s):  
Chingping Wan ◽  
Steven J. Szymkiewicz ◽  
Helmut U. Klein
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Cardioverter Defibrillator ◽  
Wear Time ◽  
Wearable Cardioverter Defibrillator ◽  
The Impact ◽  
Defibrillator Shock

scholarly journals Non-Wear Time and Presentation of Compositional 24-Hour Time-Use Analyses Influence Conclusions About Sleep and Body Mass Index in Children

2020 ◽  
Vol 3 (3) ◽  
pp. 204-210
Author(s):  
Jillian J. Haszard ◽  
Kim Meredith-Jones ◽  
Victoria Farmer ◽  
Sheila Williams ◽  
Barbara Galland ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Body Mass ◽  
Time Use ◽  
Vigorous Physical Activity ◽  
Compositional Analysis ◽  
Sleep Time ◽  
Wear Time ◽  
Children First ◽  
The Impact

Although 24-hour time-use data are increasingly being examined in relation to indices of health, consensus has yet to be reached about the best way to present estimates from compositional analyses. This analysis explored the impact of different presentations of results when assessing the relationship between 24-hour time-use and body mass index (BMI) z-score using compositional analysis of 5-day actigraphy data in 742 children. First it was found that reallocating non-wear time to day-time components only (sedentary behavior, light physical activity, and moderate-to-vigorous physical activity [MVPA]) before normalization to 24 hours provided stronger estimates with BMI z-score than simply removing non-wear time before normalization. Estimates for sleep time were substantially affected, where associations with BMI z-score nearly doubled (mean difference [95% CI] in BMI z-score for 10% longer sleep were −0.20 [−0.32, −0.08] compared to −0.11 [−0.23, 0.002]). Presenting estimates in terms of a greater number of minutes in a component, relative to all others, showed MVPA to be the strongest predictor of BMI z-score, while estimates in terms of the proportion of minutes showed sleep to be the strongest predictor. Both presentations have value. However, presentations in terms of one-to-one “substitutions” of time may need careful interpretation due to the uneven distribution of time in each component. In conclusion, when analyzing relationships between 24-hour time-use and health outcomes, non-wear time and presentation of estimates can impact final conclusions. As a result, the current understanding of the importance of sleep for child health may be underestimated.

Predictors of nonroutine discharge among patients undergoing surgery for grade I spondylolisthesis: insights from the Quality Outcomes Database

2020 ◽  
Vol 32 (4) ◽  
pp. 523-532 ◽  
Author(s):  
Praveen V. Mummaneni ◽  
Mohamad Bydon ◽  
John Knightly ◽  
Mohammed Ali Alvi ◽  
Anshit Goyal ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Acute Care ◽  
Body Mass ◽  
Care Facility ◽  
Older Age ◽  
Quality Outcomes ◽  
Acute Care Facility ◽  
Factors Associated ◽  
Patient Reported ◽  
The Impact

OBJECTIVEDischarge to an inpatient rehabilitation facility or another acute-care facility not only constitutes a postoperative challenge for patients and their care team but also contributes significantly to healthcare costs. In this era of changing dynamics of healthcare payment models in which cost overruns are being increasingly shifted to surgeons and hospitals, it is important to better understand outcomes such as discharge disposition. In the current article, the authors sought to develop a predictive model for factors associated with nonroutine discharge after surgery for grade I spondylolisthesis.METHODSThe authors queried the Quality Outcomes Database for patients with grade I lumbar degenerative spondylolisthesis who underwent a surgical intervention between July 2014 and June 2016. Only those patients enrolled in a multisite study investigating the impact of fusion on clinical and patient-reported outcomes among patients with grade I spondylolisthesis were evaluated. Nonroutine discharge was defined as those who were discharged to a postacute or nonacute-care setting in the same hospital or transferred to another acute-care facility.RESULTSOf the 608 patients eligible for inclusion, 9.4% (n = 57) had a nonroutine discharge (8.7%, n = 53 discharged to inpatient postacute or nonacute care in the same hospital and 0.7%, n = 4 transferred to another acute-care facility). Compared to patients who were discharged to home, patients who had a nonroutine discharge were more likely to have diabetes (26.3%, n = 15 vs 15.7%, n = 86, p = 0.039); impaired ambulation (26.3%, n = 15 vs 10.2%, n = 56, p < 0.001); higher Oswestry Disability Index at baseline (51 [IQR 42–62.12] vs 46 [IQR 34.4–58], p = 0.014); lower EuroQol-5D scores (0.437 [IQR 0.308–0.708] vs 0.597 [IQR 0.358–0.708], p = 0.010); higher American Society of Anesthesiologists score (3 or 4: 63.2%, n = 36 vs 36.7%, n = 201, p = 0.002); and longer length of stay (4 days [IQR 3–5] vs 2 days [IQR 1–3], p < 0.001); and were more likely to suffer a complication (14%, n = 8 vs 5.6%, n = 31, p = 0.014). On multivariable logistic regression, factors found to be independently associated with higher odds of nonroutine discharge included older age (interquartile OR 9.14, 95% CI 3.79–22.1, p < 0.001), higher body mass index (interquartile OR 2.04, 95% CI 1.31–3.25, p < 0.001), presence of depression (OR 4.28, 95% CI 1.96–9.35, p < 0.001), fusion surgery compared with decompression alone (OR 1.3, 95% CI 1.1–1.6, p < 0.001), and any complication (OR 3.9, 95% CI 1.4–10.9, p < 0.001).CONCLUSIONSIn this multisite study of a defined cohort of patients undergoing surgery for grade I spondylolisthesis, factors associated with higher odds of nonroutine discharge included older age, higher body mass index, presence of depression, and occurrence of any complication.

scholarly journals Nonalcoholic fatty liver disease and the risk of atrial fibrillation stratified by body mass index: a nationwide population-based study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
So-Ryoung Lee ◽  
Kyung-Do Han ◽  
Eue-Keun Choi ◽  
Seil Oh ◽  
Gregory Y. H. Lip
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Body Mass ◽  
Fatty Liver Disease ◽  
Nonalcoholic Fatty Liver ◽  
Increased Risk ◽  
The Impact

AbstractWe evaluated the association between nonalcoholic fatty liver disease (NAFLD) and incident atrial fibrillation (AF) and analyzed the impact of NAFLD on AF risk in relation to body mass index (BMI). A total of 8,048,055 subjects without significant liver disease who were available fatty liver index (FLI) values were included. Subjects were categorized into 3 groups based on FLI: < 30, 30 to < 60, and ≥ 60. During a median 8-year of follow-up, 534,442 subjects were newly diagnosed as AF (8.27 per 1000 person-years). Higher FLI was associated with an increased risk of AF (hazard ratio [HR] 1.053, 95% confidence interval [CI] 1.046–1.060 in 30 ≤ FLI < 60, and HR 1.115, 95% CI 1.106–1.125 in FLI ≥ 60). In underweight subjects (BMI < 18.5 kg/m2), higher FLI raised the risk of AF (by 1.6-fold in 30 ≤ FLI < 60 and by twofold in FLI ≥ 60). In normal- and overweight subjects, higher FLI was associated with an increased risk of AF, but the HRs were attenuated. In obese subjects, higher FLI was not associated with higher risk of AF. NAFLD as assessed by FLI was independently associated with an increased risk of AF in nonobese subjects with BMI < 25 kg/m2. The impact of NAFLD on AF risk was accentuated in lean subjects with underweight.

scholarly journals Long-term body mass index changes in overweight and obese adults and the risk of heart failure, cardiovascular disease and mortality: a cohort study of over 260,000 adults in the UK

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Barbara Iyen ◽  
Stephen Weng ◽  
Yana Vinogradova ◽  
Ralph K. Akyea ◽  
Nadeem Qureshi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Cohort Study ◽  
Body Mass ◽  
World Health ◽  
Obese Adults ◽  
Bmi Trajectories ◽  
The Impact

Abstract Background Although obesity is a well-recognised risk factor for cardiovascular disease (CVD), the impact of long-term body mass index (BMI) changes in overweight or obese adults, on the risk of heart failure, CVD and mortality has not been quantified. Methods This population-based cohort study used routine UK primary care electronic health data linked to secondary care and death-registry records. We identified adults who were overweight or obese, free from CVD and who had repeated BMI measures. Using group-based trajectory modelling, we examined the BMI trajectories of these individuals and then determined incidence rates of CVD, heart failure and mortality associated with the different trajectories. Cox-proportional hazards regression determined hazards ratios for incident outcomes. Results 264,230 individuals (mean age 49.5 years (SD 12.7) and mean BMI 33.8 kg/m2 (SD 6.1)) were followed-up for a median duration of 10.9 years. Four BMI trajectories were identified, corresponding at baseline, with World Health Organisation BMI classifications for overweight, class-1, class-2 and class-3 obesity respectively. In all four groups, there was a small, stable upwards trajectory in BMI (mean BMI increase of 1.06 kg/m2 (± 3.8)). Compared with overweight individuals, class-3 obese individuals had hazards ratios (HR) of 3.26 (95% CI 2.98–3.57) for heart failure, HR of 2.72 (2.58–2.87) for all-cause mortality and HR of 3.31 (2.84–3.86) for CVD-related mortality, after adjusting for baseline demographic and cardiovascular risk factors. Conclusion The majority of adults who are overweight or obese retain their degree of overweight or obesity over the long term. Individuals with stable severe obesity experience the worst heart failure, CVD and mortality outcomes. These findings highlight the high cardiovascular toll exacted by continuing failure to tackle obesity.

scholarly journals Higher body mass index is associated with larger postoperative improvement in patient-reported outcomes following total knee arthroplasty

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
K Giesinger ◽  
JM Giesinger ◽  
DF Hamilton ◽  
J Rechsteiner ◽  
A Ladurner
Keyword(s):  
Body Mass Index ◽  
Total Knee Arthroplasty ◽  
Pain Relief ◽  
Body Mass ◽  
Knee Arthroplasty ◽  
Normal Weight ◽  
World Health ◽  
Obese Patients ◽  
Total Knee ◽  
The Impact

Abstract Background Total knee arthroplasty is known to successfully alleviate pain and improve function in endstage knee osteoarthritis. However, there is some controversy with regard to the influence of obesity on clinical benefits after TKA. The aim of this study was to investigate the impact of body mass index (BMI) on improvement in pain, function and general health status following total knee arthroplasty (TKA). Methods A single-centre retrospective analysis of primary TKAs performed between 2006 and 2016 was performed. Data were collected preoperatively and 12-month postoperatively using WOMAC score and EQ-5D. Longitudinal score change was compared across the BMI categories identified by the World Health Organization. Results Data from 1565 patients [mean age 69.1, 62.2% women] were accessed. Weight distribution was: 21.2% BMI < 25.0 kg/m2, 36.9% BMI 25.0–29.9 kg/m2, 27.0% BMI 30.0–34.9 kg/m2, 10.2% BMI 35.0–39.9 kg/m2, and 4.6% BMI ≥ 40.0 kg/m2. All outcome measures improved between preoperative and 12-month follow-up (p < 0.001). In pairwise comparisons against normal weight patients, patients with class I-II obesity showed larger improvement on the WOMAC function and total score. For WOMAC pain improvements were larger for all three obesity classes. Conclusions Post-operative improvement in joint-specific outcomes was larger in obese patients compared to normal weight patients. These findings suggest that obese patients may have the greatest benefits from TKA with regard to function and pain relief one year post-op. Well balanced treatment decisions should fully account for both: Higher benefits in terms of pain relief and function as well as increased potential risks and complications. Trial registration This trial has been registered with the ethics committee of Eastern Switzerland (EKOS; Project-ID: EKOS 2020–00,879)

scholarly journals Body Mass Index, Multi-Morbidity, and COVID-19 Risk Factors as Predictors of Severe COVID-19 Outcomes

2021 ◽  
Vol 12 ◽  
pp. 215013272110185
Author(s):  
Sanjeev Nanda ◽  
Audry S. Chacin Suarez ◽  
Loren Toussaint ◽  
Ann Vincent ◽  
Karen M. Fischer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Hospital Admission ◽  
Body Mass ◽  
Risk Score ◽  
The Body ◽  
Risk Scores ◽  
Nasopharyngeal Swab ◽  
Morbidity Score ◽  
The Impact

Purpose The purpose of the present study was to investigate body mass index, multi-morbidity, and COVID-19 Risk Score as predictors of severe COVID-19 outcomes. Patients Patients from this study are from a well-characterized patient cohort collected at Mayo Clinic between January 1, 2020 and May 23, 2020; with confirmed COVID-19 diagnosis defined as a positive result on reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assays from nasopharyngeal swab specimens. Measures Demographic and clinical data were extracted from the electronic medical record. The data included: date of birth, gender, ethnicity, race, marital status, medications (active COVID-19 agents), weight and height (from which the Body Mass Index (BMI) was calculated, history of smoking, and comorbid conditions to calculate the Charlson Comorbidity Index (CCI) and the U.S Department of Health and Human Services (DHHS) multi-morbidity score. An additional COVID-19 Risk Score was also included. Outcomes included hospital admission, ICU admission, and death. Results Cox proportional hazards models were used to determine the impact on mortality or hospital admission. Age, sex, and race (white/Latino, white/non-Latino, other, did not disclose) were adjusted for in the model. Patients with higher COVID-19 Risk Scores had a significantly higher likelihood of being at least admitted to the hospital (HR = 1.80; 95% CI = 1.30, 2.50; P < .001), or experiencing death or inpatient admission (includes ICU admissions) (HR = 1.20; 95% CI = 1.02, 1.42; P = .028). Age was the only statistically significant demographic predictor, but obesity was not a significant predictor of any of the outcomes. Conclusion Age and COVID-19 Risk Scores were significant predictors of severe COVID-19 outcomes. Further work should examine the properties of the COVID-19 Risk Factors Scale.

scholarly journals The impact of late-career job loss and genetic risk on body mass index: Evidence from variance polygenic scores

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lauren L. Schmitz ◽  
Julia Goodwin ◽  
Jiacheng Miao ◽  
Qiongshi Lu ◽  
Dalton Conley
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Complex Traits ◽  
Job Loss ◽  
Past Research ◽  
Long Term Effects ◽  
Polygenic Scores ◽  
Show Evidence ◽  
Using Data ◽  
The Impact

AbstractUnemployment shocks from the COVID-19 pandemic have reignited concerns over the long-term effects of job loss on population health. Past research has highlighted the corrosive effects of unemployment on health and health behaviors. This study examines whether the effects of job loss on changes in body mass index (BMI) are moderated by genetic predisposition using data from the U.S. Health and Retirement Study (HRS). To improve detection of gene-by-environment (G × E) interplay, we interacted layoffs from business closures—a plausibly exogenous environmental exposure—with whole-genome polygenic scores (PGSs) that capture genetic contributions to both the population mean (mPGS) and variance (vPGS) of BMI. Results show evidence of genetic moderation using a vPGS (as opposed to an mPGS) and indicate genome-wide summary measures of phenotypic plasticity may further our understanding of how environmental stimuli modify the distribution of complex traits in a population.

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