Department of Emergency Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan.
Department of Emergency Medicine, National Taiwan University Medical College and Hospital, Taipei City, Taiwan.
Sci Rep. 2020 Oct 29;10(1):18638. doi: 10.1038/s41598-020-75752-9.
Cardiogenic arrest is the major cause of sudden cardiac arrest (SCA), accounting for 20% of all deaths annually. The association between obesity and outcomes in cardiac arrest survivors is debatable. However, the effect of obesity on the prognosis of patients with significant coronary artery disease (CAD) successfully resuscitated from cardiogenic arrest is unclear. Thus, the association between body mass index (BMI) and outcomes in cardiogenic arrest survivors with significant CAD was investigated. This multicentre retrospective cohort study recruited 201 patients from January 2011 to September 2017. The eligible cardiogenic arrest survivors were non-traumatic adults who had undergone emergency coronary angiography after sustained return of spontaneous circulation and had significant coronary artery stenosis. BMI was used to classify the patients into underweight, normal-weight, overweight, and obese groups (< 18.5, 18.5-24.9, 25.0-29.9, and ≥ 30 kg/m; n = 9, 87, 72, and 33, respectively). In-hospital mortality and unsatisfactory neurological outcomes (cerebral performance scale scores = 3-5) were compared among the groups. The obese group presented higher in-hospital mortality and unsatisfactory neurological outcome risks than the normal-weight group (in-hospital mortality: adjusted hazard ratio = 4.27, 95% confidence interval (CI) 1.87-12.04, P = 0.008; unsatisfactory neurological outcomes: adjusted odds ratio = 3.33, 95% CI 1.42-8.78, P = 0.009). Subgroup analysis showed significantly higher in-hospital mortality in the obese patients than in the others in each clinical characteristic. In cardiogenic arrest survivors with significant CAD, obesity was associated with high risks of mortality and unsatisfactory neurological recovery.
心源性停搏是心搏骤停（SCA）的主要原因，占每年死亡人数的 20%。肥胖与心搏骤停幸存者结局之间的关系存在争议。然而，肥胖对从心源性停搏成功复苏的有明显冠状动脉疾病（CAD）患者预后的影响尚不清楚。因此，研究了心源性停搏幸存者中体重指数（BMI）与有明显 CAD 的患者结局之间的关系。这项多中心回顾性队列研究招募了 2011 年 1 月至 2017 年 9 月期间的 201 名患者。符合条件的心源性停搏幸存者为非创伤性成年人，在自主循环持续恢复后接受了紧急冠状动脉造影检查，并存在明显的冠状动脉狭窄。BMI 用于将患者分为体重不足、正常体重、超重和肥胖组（<18.5、18.5-24.9、25.0-29.9 和≥30kg/m；n=9、87、72 和 33）。比较了各组之间的住院死亡率和不满意的神经结局（脑功能状态评分=3-5）。与正常体重组相比，肥胖组的住院死亡率和不满意的神经结局风险更高（住院死亡率：调整后的危险比=4.27，95%置信区间（CI）1.87-12.04，P=0.008；不满意的神经结局：调整后的优势比=3.33，95%CI 1.42-8.78，P=0.009）。亚组分析显示，肥胖患者在每个临床特征中都比其他患者的住院死亡率显著更高。在有明显 CAD 的心源性停搏幸存者中，肥胖与高死亡率和不满意的神经恢复相关。
