Department of Emergency Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.
Department of Emergency Medicine, National Taiwan University Medical College and Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2020 Apr;119(4):861-868. doi: 10.1016/j.jfma.2019.08.031. Epub 2019 Sep 14.
The role of body mass index (BMI) in clinical outcomes in patients resuscitated from cardiac arrest (CA) has recently drawn attention. We evaluated the effect of BMI on the prognosis of patients successfully resuscitated from cardiogenic arrest.
This retrospective cohort study included 273 non-traumatic adult cardiogenic arrest survivors receiving coronary angiography after return of spontaneous circulation in three hospitals from January 2011 to September 2017. These patients were classified as underweight, normal-weight, overweight, and obese, based on BMI (<18.5; 18.5-24.9; 25.0-29.9; and ≥30 kg/m, respectively). In-hospital mortality and poor neurological outcomes were compared among groups.
The obese group had significantly higher rates of in-hospital mortality and poor neurological outcomes (cerebral performance scale = 3-5) than did the other groups (for underweight, normal-weight, overweight, and obese groups, in-hospital mortality rates were 38.5%, 29.8%, 39.0%, and 64.1%, respectively, p = 0.002; poor neurological outcomes were 53.9%, 43.8%, 47.0%, and 71.8%, respectively, p = 0.02). The obese group exhibited higher risks of in-hospital mortality and poor neurological outcomes than did the normal-weight group (in-hospital mortality: adjusted hazard ratio (aHR) = 5.21, 95% confidence interval (CI) 2.16-10.32, p < 0.001; poor neurological outcomes: aHR = 3.77, 95% CI 1.69-8.36, p = 0.002).
Obesity was associated with higher risks of in-hospital mortality and poor neurological recovery.
体重指数（BMI）在心脏骤停（CA）复苏患者的临床结局中的作用最近引起了关注。我们评估了 BMI 对心源性停搏后成功复苏患者预后的影响。
本回顾性队列研究纳入了 2011 年 1 月至 2017 年 9 月期间在三所医院接受冠状动脉造影的 273 例非创伤性成年心源性停搏幸存者。这些患者根据 BMI（<18.5；18.5-24.9；25.0-29.9；和≥30kg/m 分别归类为体重不足、正常体重、超重和肥胖。比较了各组患者的住院死亡率和不良神经结局。
肥胖组的住院死亡率和不良神经结局（脑功能状态评分 3-5）明显高于其他组（体重不足、正常体重、超重和肥胖组的住院死亡率分别为 38.5%、29.8%、39.0%和 64.1%，p=0.002；不良神经结局分别为 53.9%、43.8%、47.0%和 71.8%，p=0.02）。肥胖组的住院死亡率和不良神经结局风险高于正常体重组（住院死亡率：调整后的危险比（aHR）=5.21，95%置信区间（CI）2.16-10.32，p<0.001；不良神经结局：aHR=3.77，95%CI 1.69-8.36，p=0.002）。
肥胖与住院死亡率和不良神经恢复风险增加相关。
