Abstract 3306: Effect Of General Obesity On Neurological Deterioration After Acute Stroke
Objective: The increasing prevalence of obesity in Asia has led to concern that obesity negatively affects outcomes after acute cardiovascular events and stroke. Here, we examined the relationship between body mass index (BMI), as a general indicator of obesity, and neurological deterioration after acute stroke.
Patients and Methods: Consecutive acute stroke patients (n=2310: 489 hemorrhagic stroke, 1702 ischemic stroke, 119 TIA; median age 73.0; 1392 male) participated in this study. All patients were admitted within 7 days of stroke onset to a regional brain attack center in Japan between January 2005 and December 2010, and provided written informed consent. Patient attributes (age; sex; current smoking and/or drinking status; past history of stroke, hypertension, diabetes mellitus, and hypercholesterolemia; and body weight and height) were recorded upon admission; BMI was calculated using the height and weight measurements. Patients whose NIHSS score increased by 4 or more from admission to discharge or who died during hospitalization were classified into the neurological deterioration group; all other patients were classified into the non-deterioration group. Logistic regression analysis was performed using the deterioration and non-deterioration groups as dependent variables, and factors related to deterioration were examined using SPSS version 15.0.
Results: The deterioration group comprised 221 patients, and had a higher proportion of patients with hypertension and/or diabetes mellitus and age over 75 years, but these patients had significantly lower BMI values than the 2089 patients in the non-deterioration group (22.4 ± 4.2 kg/m2 vs. 23.2 ± 3.5, p=0.002). No intergroup differences were observed for history of stroke, smoking and/or drinking status, or hypercholesterolemia. Logistic regression analysis of the patient attributes listed above indicated that age and history of hypertension (odds ratio=1.77 and 1.75, 95% CI: 1.24-2.52 and 1.07-2.85, respectively) were positively correlated with neurological deterioration; in contrast, a larger BMI was negatively correlated with neurological deterioration (odds ratio by 1 kg/m2 increase in BMI=0.948, 95% CI: 0.899-0.999, p=0.04).
Conclusion: Lower BMI at admission was positively correlated with neurological deterioration after acute stroke after adjusting for other cerebrovascular risk factors.
- © 2012 by American Heart Association, Inc.