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Body mass index and clinical outcomes in patients after ischaemic stroke in South Korea: a retrospective cohort study
OBJECTIVES: Although obesity is a risk factor for stroke, its impact on mortality in patients with stroke remains unclear. In this study, we aimed to evaluate the relationship between body mass index (BMI) and mortality due to ischaemic stroke among adults aged 20 years and above in Korea. DESIGN: R...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719766/ https://www.ncbi.nlm.nih.gov/pubmed/31446408 http://dx.doi.org/10.1136/bmjopen-2018-028880 |
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author | Choi, HeeKyoung Nam, Hyo Suk Han, Euna |
author_facet | Choi, HeeKyoung Nam, Hyo Suk Han, Euna |
author_sort | Choi, HeeKyoung |
collection | PubMed |
description | OBJECTIVES: Although obesity is a risk factor for stroke, its impact on mortality in patients with stroke remains unclear. In this study, we aimed to evaluate the relationship between body mass index (BMI) and mortality due to ischaemic stroke among adults aged 20 years and above in Korea. DESIGN: Retrospective cohort study. SETTING: A tertiary-hospital-based stroke registry linked to the death records. PARTICIPANTS: 3599 patients admitted for ischaemic stroke from January 2007 to June 2013. OUTCOME MEASURES: The HRs for all-cause and stroke-related mortality were calculated using Cox proportional hazards models. Progression from stroke-related mortality was assessed using the Fine-Grey competing risk model, treating other-cause mortality as a competing risk. Adjustments were made for age, gender, smoking status, Charlson comorbidity index, cardiovascular or non-cardiovascular comorbidities, stroke severity, severity related to other medical conditions, complications and enrolment year. We repeated the analysis with stratification based on age groups (less than 65 vs 65 years and above). RESULTS: For stroke-related mortality, there was no significant difference among the four BMI groups. The risk of all-cause mortality was 36% higher in the underweight group than in the normal weight group (long-term HR=1.36, 95% CI: 1.04 to 1.79), whereas the mortality risk of the obese group was significantly lower (HR=0.66, 95% CI: 0.54 to 0.81). Although this relationship was not estimated in the younger group, it was found that obesity had a protective effect on the all-cause mortality in the elderly (long-term HR=0.66, 95% CI: 0.52 to 0.83). CONCLUSIONS: Obesity is more likely to reduce mortality risk than normal weight, especially in elderly patients. |
format | Online Article Text |
id | pubmed-6719766 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-67197662019-09-17 Body mass index and clinical outcomes in patients after ischaemic stroke in South Korea: a retrospective cohort study Choi, HeeKyoung Nam, Hyo Suk Han, Euna BMJ Open Epidemiology OBJECTIVES: Although obesity is a risk factor for stroke, its impact on mortality in patients with stroke remains unclear. In this study, we aimed to evaluate the relationship between body mass index (BMI) and mortality due to ischaemic stroke among adults aged 20 years and above in Korea. DESIGN: Retrospective cohort study. SETTING: A tertiary-hospital-based stroke registry linked to the death records. PARTICIPANTS: 3599 patients admitted for ischaemic stroke from January 2007 to June 2013. OUTCOME MEASURES: The HRs for all-cause and stroke-related mortality were calculated using Cox proportional hazards models. Progression from stroke-related mortality was assessed using the Fine-Grey competing risk model, treating other-cause mortality as a competing risk. Adjustments were made for age, gender, smoking status, Charlson comorbidity index, cardiovascular or non-cardiovascular comorbidities, stroke severity, severity related to other medical conditions, complications and enrolment year. We repeated the analysis with stratification based on age groups (less than 65 vs 65 years and above). RESULTS: For stroke-related mortality, there was no significant difference among the four BMI groups. The risk of all-cause mortality was 36% higher in the underweight group than in the normal weight group (long-term HR=1.36, 95% CI: 1.04 to 1.79), whereas the mortality risk of the obese group was significantly lower (HR=0.66, 95% CI: 0.54 to 0.81). Although this relationship was not estimated in the younger group, it was found that obesity had a protective effect on the all-cause mortality in the elderly (long-term HR=0.66, 95% CI: 0.52 to 0.83). CONCLUSIONS: Obesity is more likely to reduce mortality risk than normal weight, especially in elderly patients. BMJ Publishing Group 2019-08-24 /pmc/articles/PMC6719766/ /pubmed/31446408 http://dx.doi.org/10.1136/bmjopen-2018-028880 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Epidemiology Choi, HeeKyoung Nam, Hyo Suk Han, Euna Body mass index and clinical outcomes in patients after ischaemic stroke in South Korea: a retrospective cohort study |
title | Body mass index and clinical outcomes in patients after ischaemic stroke in South Korea: a retrospective cohort study |
title_full | Body mass index and clinical outcomes in patients after ischaemic stroke in South Korea: a retrospective cohort study |
title_fullStr | Body mass index and clinical outcomes in patients after ischaemic stroke in South Korea: a retrospective cohort study |
title_full_unstemmed | Body mass index and clinical outcomes in patients after ischaemic stroke in South Korea: a retrospective cohort study |
title_short | Body mass index and clinical outcomes in patients after ischaemic stroke in South Korea: a retrospective cohort study |
title_sort | body mass index and clinical outcomes in patients after ischaemic stroke in south korea: a retrospective cohort study |
topic | Epidemiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719766/ https://www.ncbi.nlm.nih.gov/pubmed/31446408 http://dx.doi.org/10.1136/bmjopen-2018-028880 |
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