The Relationship Between Body Mass Index and In-hospital Survival in Patients Admitted With Acute Heart Failure

被引:5
作者
Elbaz-Greener, Gabby [1 ,2 ]
Rozen, Guy [3 ,4 ,5 ]
Carasso, Shemy [6 ,7 ]
Yarkoni, Merav [1 ,2 ]
Wijeysundera, Harindra C. [8 ]
Alcalai, Ronny [1 ,2 ]
Gotsman, Israel [1 ,2 ]
Rahamim, Eldad [1 ,2 ]
Planer, David [1 ,2 ]
Amir, Offer [1 ,2 ,7 ]
机构
[1] Hadassah Med Ctr, Dept Cardiol, Jerusalem, Israel
[2] Hebrew Univ Jerusalem, Fac Med, Jerusalem, Israel
[3] Hillel Yaffe Med Ctr, Div Cardiol, Hadera, Israel
[4] Technion, Ruth & Bruce Rappaport Fac Med, Haifa, Israel
[5] Harvard Med Sch, Div Cardiol, Massachusetts Gen Hosp, Boston, MA 02115 USA
[6] Baruch Padeh Med Ctr, Div Cardiovasc Med, Poriya, Israel
[7] Bar Ilan Univ, Azrieli Fac Med Galilee, Safed, Israel
[8] Univ Toronto, Div Cardiol, Schulich Heart Ctr, Sunnybrook Hlth Sci Ctr, Toronto, ON, Canada
关键词
body mass index; BMI; acute heart failure; AHF; outcome; OBESITY PARADOX; COMORBIDITY INDEX; RISK-FACTOR; MORTALITY; ASSOCIATION; PROGNOSIS; INSIGHTS; DISEASE; BMI;
D O I
10.3389/fcvm.2022.855525
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BackgroundThe association between Body Mass Index (BMI) and clinical outcomes following acute heart failure (AHF) hospitalization is debated in the literature. Our objective was to study the real-world relationship between BMI and in-hospital mortality in patients who were admitted with AHF. MethodsIn this retrospective, multi-center study, we utilized the National Inpatient Sample (NIS) database to identify a sampled cohort of patients who were hospitalized with AHF between October 2015 and December 2016. Outcomes of interest included in-hospital mortality and length of stay (LOS). Patients were divided into 6 BMI (kg/m(2)) subgroups according to the World Health Organization (WHO) classification: (1) underweight <= 19, (2) normal weight 20-25, (3) overweight 26-30, (4) obese I 31-35, (5) obese II 36-39, and (6) extremely obese >= 40. A multivariable logistic regression model was used to identify predictors of in-hospital mortality and to identify predictors of LOS. ResultsA weighted total of 219,950 hospitalizations for AHF across the US were analyzed. The mean age was 66.3 +/- 31.5 years and most patients (51.8%) were male. The crude data showed a non-linear complex relationship between BMI and AHF population outcomes. Patients with elevated BMI exhibited significantly lower in-hospital mortality compared to the underweight and normal weight study participants (5.5, 5,5, 2,8, 1.6, 1.4, 1.6% in groups by BMI <= 19, 20-25, 26-30, 31-35, 36-39, and, >= 40 respectively, p < 0.001) and shorter LOS. In the multivariable regression model, BMI subgroups of <= 25kg/m(2) were found to be independent predictors of in-hospital mortality. Age and several comorbidities, and also the Deyo Comorbidity Index, were found to be independent predictors of increased mortality in the study population. ConclusionA reverse J-shaped relationship between BMI and mortality was documented in patients hospitalized for AHF in the recent years confirming the "obesity paradox" in the real-world setting.
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页数:9
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