Abstract 17049: Obesity and Prognosis in Patients with Acute Cerebrovascular Accident
Introduction: Limited data exist concerning the impact of obesity on prognosis in patients with acute cerebrovascular accident (CVA). Some of the published data suggest a paradoxically better outcome in obese patients with CVA while others have failed to find such an association and this relation remains unclear.
Hypothesis: We examined the impact of obesity on in-hospital mortality in patients presenting with acute ischemic CVA in a large sample representative of the US population.
Methods: The Nationwide Inpatient Sample, part of the Healthcare Cost and Utilization Project, is the largest publicly available inpatient database designed to provide information on characteristics and outcomes of patients discharged from United States community hospitals. Using the Nationwide Inpatient Sample, we identified 455006 adult patient discharges, with a primary discharge diagnosis of ischemic stroke or TIA. Among those, 31723 had a diagnosis of obesity.
Results: Patients with obesity were in general younger (63 yrs. vs. 72 yrs. p<0.001), with a higher proportion of females (57% vs. 52%, p<0.001), and a higher frequency of hypertension (71% vs. 66%, p<0.001), and diabetes mellitus (55% vs. 30%, p<0.001. Obese patients were less likely to have atrial fibrillation (13% vs. 18%, p< 0.001). The in-hospital mortality rate for patients with acute CVA and obesity was 1.8%, compared to 3.2% in patients without obesity (p<0.001). After adjusting for pertinent clinical variables using logistic regression analysis, obesity remained an independent predictor of lower in-hospital mortality (p<0.001, OR 0.82[0.75-0.89]).
Conclusions: In patients presenting with acute cerebrovascular accident, obesity is associated with lower in-hospital mortality.
Author Disclosures: S. Hayek: None. N. Zeineh: None. D. Lasorda: None. R. Hajjali: None.
- © 2014 by American Heart Association, Inc.