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J Neurocrit Care 2013;6(2): 92-96.
Relationship of Body Mass Index and Mortality for Acute Ischemic Stroke Patients after Thrombolysis Therapy
Jung Hwa Seo, MD, Hye Young Jeong, MD, Sangwoo Noh, MD, Eung-Gyu Kim, MD, PhD, Ki-Hwan Ji, MD, Jong Seok Bae, MD, and Sang-Jin Kim, MD
Department of Neurology, Pusan Paik Hospital, Inje University College of Medicine, Busan, Korea
ABSTRACT
Background: Obesity has been established as a risk factor for ischemic stroke and coronary disease, but several studies have suggested that obese and overweight stroke patients have significantly better long-term survival rates. This study investigated the association between body mass index (BMI) and mortality in acute ischemic stroke patients treated with thrombolysis therapy.
Methods: During the 8-year study period, data on 321 patients treated with thrombolysis therapy, including intravenous recombinant tissue plasminogen activator and/or intra-arterial thrombolysis, were collected. The study participants were divided into four groups according to BMI: underweight (<18.5 kg/m2), normal weight (18.5-22.9 kg/m2), overweight (23.0-24.9 kg/m2), and obese (≥25.0 kg/m2). Information about longterm mortality was collected until March 2013.
Results: Fourteen patients were underweight, 123 were normal weight, 90 were overweight, and 94 were obese. The age and the National Institutes of Health Stroke Scale scores of underweight stroke patients on admission were significantly higher than were those of other BMI groups. Ninety-three patients died during the follow-up period, and 90- day and long-term mortality tended to be higher in underweight patients. According to the adjusted Cox proportional-hazards regression analysis, long-term mortality was associated only with being underweight.
Conclusions: Among stroke patients, being underweight may be independently associated with poorer long-term survival compared with being with normal weight.
Key Words: Obesity · Body mass index · Cerebral infarction · Thrombolytic therapy · Mortality
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