国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
2021-02-01
已发表文章
主要研究背景及目的
Background: Intracerebral Hemorrhage (ICH) is one of the most common causes of morbidity and mortality worldwide accounting for 10-15 % of all strokes. Obesity is now considered to be a global epidemic, and relative to normal body weight, obesity is associated with increased all-cause mortality. But it has been shown to be protective in several disease states, such as heart failure, coronary artery disease, and diabetes mellitus, and more recently even in patients with pneumonia. However, obesity’s impact on mortality in patients with intracerebral hemorrhage (ICH) remains unclear. Objectives: To evaluate the association of body mass index (BMI) with in-hospital mortality and complications among ICH patients.
方法
Data were from 85 705 ICH enrolled in the China Stroke Center Alliance study. Patients were divided into four groups: underweight, normal weight, overweight and obese according to Asian-Pacific criteria. The primary outcome was in-hospital mortality. The secondary outcomes included non-routine discharge disposition and in-hospital complications. Discharge to graded II or III hospital, community hospital or rehabilitation facilities was considered non-routine disposition. Multivariable logistic regression analysed association of BMI with outcomes.
结论
In patients with ICH, being underweight was associated with increased in-hospital mortality. Being underweight and obese can both increased risk of in-hospital complications compared with having normal weight.
主要结果
82 789 patients with ICH were included in the final analysis. Underweight (OR=2.057, 95% CI 1.193 to 3.550) patients had higher odds of in-hospital mortality than those with normal weight after adjusting for covariates, but no significant difference was observed for patients who were overweight or obese. No significant association was found between BMI and non-disposition. Underweight was associated with increased odds of several complications, including pneumonia (OR 1.343, 95% CI 1.138 to 1.584), poor swallow function (OR 1.351, 95% CI 1.122 to 1.628) and urinary tract infection (OR 1.532, 95% CI 1.064 to 2.204). Moreover, obese patients had higher odds of haematoma expansion (OR 1.326, 95% CI 1.168 to 1.504), deep vein thrombosis (OR 1.506, 95% CI 1.165 to 1.947) and gastrointestinal bleeding (OR 1.257, 95% CI 1.027 to 1.539).