Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, PR China; Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, PR China.
Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, PR China; Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, PR China.
Am J Emerg Med. 2021 May;43:97-102. doi: 10.1016/j.ajem.2021.01.003. Epub 2021 Jan 29.
The association between body mass index (BMI) and all-cause mortality of patients with Cardiogenic Shock (CS) is still controversial. The objective of this analysis is to summarize the available evidence of this association and perform meta-analysis using adjusted estimates.
PubMed, Embase and Cochrane databases were systematically searched for eligible studies up to July 2020. Studies were considered eligible if they described the association between BMI and all-cause mortality of patients with CS, and those reporting adjusted estimates were included in the meta-analysis.
Three studies were identified and included total 345,281 participants. The pooled hazard ratio of all-cause mortality was 0.88(95% confidence interval (CI): 0.71-1.08, P = 0.23) when compared obesity with non-obese. In subgroup analysis, A subgroup analysis based on geographic region showed that obese patients had lower mortality compared with non-obese patients (OR = 0.71,95% CI 0.65-0.77, P < 0.00001) in USA, developed country and the retrospective study. Heterogeneity was not explained in pre-specified subgroups analysis.
Obesity was associated with increased adjusted all-cause mortality of patients with Cardiogenic Shock when compared to non-obese. Unexplained heterogeneity and suboptimal quality of studies limit the strength of the results. This seemingly paradoxical finding needs to be confirmed with further research.
体重指数（BMI）与心源性休克（CS）患者全因死亡率之间的关系仍存在争议。本分析的目的是总结这方面的现有证据，并使用调整后的估计值进行荟萃分析。
系统检索了 PubMed、Embase 和 Cochrane 数据库，以获取截至 2020 年 7 月的合格研究。如果研究描述了 BMI 与 CS 患者全因死亡率之间的关系，并且报告了调整后的估计值，则认为其符合纳入标准，并纳入荟萃分析。
确定了 3 项研究，共纳入 345281 名参与者。与非肥胖者相比，肥胖者的全因死亡率的合并风险比为 0.88（95%置信区间（CI）：0.71-1.08，P=0.23）。亚组分析显示，基于地理位置的亚组分析表明，与非肥胖者相比，肥胖者的死亡率较低（OR=0.71，95%CI 0.65-0.77，P<0.00001），这在美国、发达国家和回顾性研究中均如此。在预先指定的亚组分析中，无法解释异质性。
与非肥胖者相比，肥胖与心源性休克患者调整后的全因死亡率增加相关。未解释的异质性和研究质量欠佳限制了结果的强度。这一看似矛盾的发现需要进一步的研究来证实。
