Association of elevated body mass index with mortality following acute ischemic stroke: The obesity paradox revisited

2021 ◽  
Vol 429 ◽  
pp. 119702
Author(s):  
Alis Dicpinigaitis ◽  
Chirag Gandhi ◽  
Stephan Mayer ◽  
Fawaz Al-Mufti
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Body Mass ◽  
Obesity Paradox ◽  
Elevated Body Mass Index

Abstract WP43: Body Mass Index and Clinical Outcomes in Large Vessel Occlusion Acute Ischemic Stroke After Endovascular Therapy: The Obesity Paradox

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Mehdi Bouslama ◽  
Hilarie Perez ◽  
Letícia C Rebello ◽  
Diogo C Haussen ◽  
Jonathan A Grossberg ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Clinical Outcomes ◽  
Body Mass ◽  
Endovascular Therapy ◽  
Obesity Paradox ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion

Abstract P72: The Obesity Paradox: Association Between Body Mass Index (BMI) and Disability After Stroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Brianna R Helms
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Functional Status ◽  
Hospital Discharge ◽  
Body Mass ◽  
Obesity Paradox ◽  
Normal Weight ◽  
Stroke Recurrence ◽  
Inverse Association ◽  
Stroke Patients

Background: Present rise in the incidence of obesity has led to several opposing reports regarding the association between obesity and stroke outcomes. The objective of this study was to investigate a proposed paradoxical relationship between body mass index (BMI) and functional status in ischemic stroke patients at time of hospital discharge. Methods: Saint Francis Hospital Comprehensive Stroke Center patient databases were utilized in identifying 948 patients eligible for retrospective chart review over a period of 15 months. Subjects were divided into 4 groups according to BMI: underweight (BMI < 18.5 kg/m 2 ), normal weight (BMI 18.5-24.9 kg/m 2 ), overweight (BMI 25.0-29.9 kg/m 2 ), and obese (BMI ≥ 30.0 kg/m 2 ). Covariates, such as age, gender, prior to event modified Rankin scale (mRS), stroke recurrence, and smoking, were considered. Functional status and disability of stroke patients was scored via mRS at hospital discharge. Ordered logistic regression, Pearson’s chi-squared test, and Pearson’s r correlation were used for analysis to assess the association of BMI and functional status in ischemic strokes. Results: Of 948 eligible subjects, 49.9% were female and mean (SD) age was 69.4 (14.5) years. According to BMI, 22 (2.3%) were underweight, 247 (26.1%) normal weight, 319 (33.7%) overweight, and 360 (37.9%) obese. After adjusting for covariates, ischemic stroke patients with an increased BMI (OR, 0.98; 95% CI, 0.96-0.99) were not associated with increased disability risk upon discharge. Obese (16.2%) and overweight (14.1%) patients discharged with a mRS of 0 (back to baseline) or 1 more frequently compared to normal weight (6.1%) and underweight (0.21%) patients ( P <0.001). Furthermore, an inverse association between BMI status and disability was significantly evident ( r = -0.17, P < 0.001). Conclusion: Obese and overweight stroke patients discharge with a lower risk of disability than normal weight and underweight patients, supporting the existence of the “obesity paradox” in stroke. An inverse association between obesity status and functional outcome was identified and remained significant regardless of covariates.

scholarly journals Association of body mass index with mortality and functional outcome after acute ischemic stroke

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Weiping Sun ◽  
Yining Huang ◽  
Ying Xian ◽  
Sainan Zhu ◽  
Zhirong Jia ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Body Mass

Abstract WP25: The Impact of Body Mass Index on Outcomes of Mechanical Thrombectomy for Acute Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Stephanie Chen ◽  
David McCarthy ◽  
Vasu Saini ◽  
Marie Brunet ◽  
Eric Peterson ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Body Mass ◽  
Linear Correlation ◽  
Mechanical Thrombectomy ◽  
Functional Independence ◽  
Normal Weight ◽  
Vessel Occlusion ◽  
The Impact

Background: Obesity is an established risk factor for acute ischemic stroke (AIS), but its impact on clinical outcomes and mortality after AIS remains controversial. In this study, we evaluate the association of body mass index (BMI) on outcomes after mechanical thrombectomy (MT) for large vessel occlusion acute ischemic stroke (LVOS). Methods: We reviewed our prospective MT database for LVOS between 2015 and 2018. BMI was analyzed as a continuous and categorical variable with underweight BMI <18.5, normal BMI 18.5-24.9, overweight BMI 25-29.9, and obese BMI>30. Multivariate analysis was used to determine predictors of outcome. Results: 335 patients underwent MT with 7 (2.1%) patients classified as underweight, 107 (31.9%) normal, 141 (42.1%) overweight, and 80 (23.9%) obese. Compared to normal weight (reference), obese patients had higher rates of hypertension and hyperlipidemia, while underweight patients had higher rates of previous stroke and presentation NIHSS. The time from symptom onset to puncture, procedural techniques, and reperfusion success (>TICI 2b) was not significantly different between BMI categories. There was a significant inverse linear correlation between BMI and symptomatic hemorrhagic. In patients with successful reperfusion (>TICI 2b), there was also a significant bell-shaped relationship between BMI and functional independence (mRS < 3) with both low and high BMIs associated with worse outcomes. In patients without post-procedural symptomatic hemorrhage, there was a significant linear correlation between BMI and inpatient mortality. Conclusion: In LVOS patients treated with MT, BMI is inversely related with post-procedural symptomatic hemorrhage. Yet in those whom reperfusion is achieved, both lower and higher than normal BMI were associated with worse functional outcomes. Thus, the obesity paradox does not appear to pertain to mechanical thrombectomy, although larger prospective studies are necessary.

scholarly journals Association of Body Mass Index and Mortality After Acute Ischemic Stroke

2013 ◽  
Vol 7 (1) ◽  
pp. 64-69 ◽  
Author(s):  
L. E. Skolarus ◽  
B. N. Sanchez ◽  
D. A. Levine ◽  
J. Baek ◽  
K. A. Kerber ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Body Mass

Association between body mass index and the effect of antihypertensive treatment on the long-term outcome of patients with acute ischemic stroke

2015 ◽  
Vol 9 (4) ◽  
pp. e122
Author(s):  
Konstantinos Tziomalos ◽  
Stella Bouziana ◽  
Marianna Spanou ◽  
Stavroula Kostaki ◽  
Maria Papadopoulou ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Body Mass ◽  
Antihypertensive Treatment ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Body mass index is a risk factor for hemorrhagic transformation in older ischemic stroke patients after intravenous thrombolysis: a single center retrospective study

2019 ◽  
Author(s):  
Changqing Miao ◽  
Xiaoyan Yin ◽  
Chunying Mu ◽  
Yan Qu ◽  
Guogang Luo ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Confidence Interval ◽  
Acute Ischemic Stroke ◽  
Body Mass ◽  
Odds Ratio ◽  
Intravenous Thrombolysis ◽  
Hemorrhagic Transformation ◽  
Stroke Patients ◽  
Tomography Scan

Abstract Background: The aim of our study was to determine whether body mass index is a predictor of hemorrhagic transformation in acute ischemic stroke patients after intravenous thrombolysis. Methods: A retrospective observational study was conducted to recruit 261 participants from a single center in China (67.0% males, median age 65 years). A head computed tomography scan was performed after 24 hours to evaluate hemorrhagic transformation occurrence, and a computed tomography scan was performed immediately in cases of clinical worsening. Multivariate logistic regression was used to estimate the association between risk factors and hemorrhagic transformation in acute ischemic stroke patients after intravenous administration of recombinant tissue plasminogen activator. Results: Of 261 patients, 40 (15.3%) developed hemorrhagic transformation (55% males, median age 70 years). Body mass index was higher in patients with hemorrhagic transformation than in patients without hemorrhagic transformation (25.7 vs 23.7; P value, 0.013). The multivariate logistic regression model showed that body mass index was an independent predictor of hemorrhagic transformation in patients aged ≥ 73 years (odds ratio, 1.74; 95% confidence interval, 1.22-2.49) but not in patients aged < 73 years (odds ratio, 1.01; 95% confidence interval, 0.87-1.18). In addition, the odds ratio was 5.16 (95% confidence interval, 2.21-12.04) when the body mass index was ≥ 25 kg/m2 compared to a body mass index < 25 kg/m2. Conclusions: The present study demonstrated that body mass index was an independent predictor of hemorrhagic transformation in older acute ischemic stroke patients after intravenous thrombolysis. Keywords: Body mass index, Hemorrhagic transformation, Intravenous thrombolysis, Ischemic stroke, Older patients.

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