Association Between Obesity and Mortality After Acute First-Ever Stroke
Top Cited Papers
- 1 January 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 42 (1), 30-36
- https://doi.org/10.1161/strokeaha.110.593434
Abstract
Background and Purpose— Limited data exist concerning obesity and survival in patients after acute stroke. The objective of this study was to investigate the association between obesity and survival in patients with acute first-ever stroke. Methods— Patients were prospectively investigated based on a standard diagnostic protocol over a period of 16 years. Evaluation was performed on admission, at 7 days, at 1, 3, and 6 months after discharge, and yearly thereafter for up to 10 years after stroke. The study patients were divided into 3 groups according to body mass index (BMI): normal weight (2), overweight (25–29.9 kg/m2), and obese (≥30 kg/m2). Overall survival during follow-up was the primary end point. The secondary end point was the overall composite cardiovascular events over the study period. Results— Based on our inclusion criteria, 2785 patients were recruited. According to BMI, 1138 (40.9%) patients were of normal weight, 1113 (41.0%) were overweight, and 504 (18.1%) were obese. NIHSS score on admission (mean, 11.28±8.65) was not different among the study groups. Early (first week) survival in obese (96.4%; 95% CI, 94.8%–97.9%) and overweight patients (92.8%; 95% CI, 91.2%–94.4%) was significantly higher compared to that of normal-weight patients (90.2%; 95% CI, 88.4%–92.0%). Similarly, 10-year survival was 52.5% (95% CI, 46.4%–58.6%) in obese, 47.4% (95% CI, 43.5%–51.3%) in overweight, and 41.5% (95% CI, 39.7%–45.0%) in normal-weight patients (log-rank test=17.7; P<0.0001). Overweight (HR, 0.82; 95% CI, 0.71–0.94) and obese patients (HR, 0.71; 95% CI, 0.59–0.86) had a significantly lower risk of 10-year mortality compared to normal-weight patients after adjusting for all confounding variables. Conclusions— Based on BMI estimation, obese and overweight stroke patients have significantly better early and long-term survival rates compared to those with normal BMI.Keywords
This publication has 37 references indexed in Scilit:
- Excess Body Weight and Incidence of Stroke Meta-Analysis of Prospective Studies With 2 Million ParticipantsStroke, 2010
- The Impact of Body Mass Index on Mortality After StrokeStroke, 2009
- Contribution of Obesity and Abdominal Fat Mass to Risk of Stroke and Transient Ischemic AttacksStroke, 2008
- Body Mass Index, Blood Pressure, and Mortality From StrokeStroke, 2008
- Body Fat Distribution and Long-Term Risk of Stroke MortalityStroke, 2005
- Body Mass Index and Ischemic and Hemorrhagic StrokeStroke, 2004
- Body-Mass Index and Mortality in a Prospective Cohort of U.S. AdultsNew England Journal of Medicine, 1999
- Intracerebral Hemorrhage After Intravenous t-PA Therapy for Ischemic StrokeStroke, 1997
- Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.Stroke, 1993
- Measurements of acute cerebral infarction: a clinical examination scale.Stroke, 1989