Department of Neurology, University at Buffalo, State University of New York, Buffalo, New York, USA.
Departments of Neurology and Neurosurgery, University of Cincinnati Medical Center, Cincinnati, Ohio, USA.
Cerebrovasc Dis. 2021;50(2):141-146. doi: 10.1159/000511489. Epub 2021 Jan 8.
We sought to investigate the effect of obesity and BMI on functional outcome and rate of symptomatic intracranial hemorrhage (sICH) in a large sample of patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT).
In a single-center retrospective, but prospectively collected data, study of patients with AIS treated with IVT in a 10-year period, patients were placed into groups based on their BMI defined as underweight (<18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), or obese (<30 kg/m2). The rate of sICH and discharge modified Rankin Scale (mRS) were compared between the groups using logistic regression analysis.
In a total of 834 patients who received IVT for AIS during a 10-year period, 224 (27.0%) were obese. Obese patients did not have a higher rate of sICH after IVT for AIS on the unadjusted or adjusted analysis (adjusted OR 0.95, 95% CI 0.48-1.88). We did not find an association between obesity and poor functional outcome at discharge (adjusted OR 0.76, 95% CI 0.53-1.09).
After adjusting for confounding factors such as age, baseline National Institute of Health Stroke Scale (NIHSS), and comorbidities, obesity was not associated with an unfavorable functional outcome at discharge nor with a higher risk of sICH in patients with AIS treated with IVT.
我们旨在研究肥胖和 BMI 对接受静脉溶栓治疗的大量急性缺血性脑卒中(AIS)患者的功能结局和症状性颅内出血(sICH)发生率的影响。
在一项为期 10 年的单中心回顾性但前瞻性收集数据的研究中,根据 BMI 将接受 IVT 治疗的 AIS 患者分为以下几组:体重不足(<18.5kg/m2)、正常体重(18.5-24.9kg/m2)、超重(25-29.9kg/m2)或肥胖(<30kg/m2)。使用逻辑回归分析比较各组之间 sICH 和出院时改良 Rankin 量表(mRS)的发生率。
在 10 年内接受 IVT 治疗的 834 名 AIS 患者中,有 224 名(27.0%)为肥胖患者。未调整或调整分析均未发现肥胖患者在接受 IVT 治疗后 AIS 的 sICH 发生率更高(调整后的 OR 0.95,95%CI 0.48-1.88)。我们未发现肥胖与出院时功能结局不良之间存在关联(调整后的 OR 0.76,95%CI 0.53-1.09)。
在调整了年龄、基线国立卫生研究院卒中量表(NIHSS)和合并症等混杂因素后,肥胖与接受 IVT 治疗的 AIS 患者出院时的不良功能结局无关,也与 sICH 风险增加无关。