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Impact of body mass index on outcome in stroke patients treated with intravenous thrombolysis
Author(s) -
Gensicke H.,
Wicht A.,
Bill O.,
Zini A.,
Costa P.,
Kägi G.,
Stark R.,
Seiffge D. J.,
Traenka C.,
Peters N.,
Bonati L. H.,
Giovannini G.,
De Marchis G. M.,
Poli L.,
Polymeris A.,
Vanacker P.,
Sarikaya H.,
Lyrer P. A.,
Pezzini A.,
Vandelli L.,
Michel P.,
Engelter S. T.
Publication year - 2016
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13071
Subject(s) - medicine , underweight , overweight , body mass index , modified rankin scale , odds ratio , stroke (engine) , obesity paradox , thrombolysis , confidence interval , surgery , ischemic stroke , myocardial infarction , mechanical engineering , ischemia , engineering
Background and purpose The impact of body mass index ( BMI ) on outcome in stroke patients treated with intravenous thrombolysis ( IVT ) was investigated. Methods In a multicentre IVT ‐register‐based observational study, BMI with (i) poor 3‐month outcome (i.e. modified Rankin Scale scores 3–6), (ii) death and (iii) symptomatic intracranial haemorrhage ( sICH ) based on criteria of the ECASS II trial was compared. BMI was used as a continuous and categorical variable distinguishing normal weight (reference group 18.5–24.9 kg/m 2 ) from underweight (<18.5 kg/m 2 ), overweight (25–29.9 kg/m 2 ) and obese (≥30 kg/m 2 ) patients. Univariable and multivariable regression analyses with adjustments for age and stroke severity were done and odds ratios with 95% confidence intervals [OR (95% CI)] were calculated. Results Of 1798 patients, 730 (40.6%) were normal weight, 55 (3.1%) were underweight, 717 (39.9%) overweight and 295 (16.4%) obese. Poor outcome occurred in 38.1% of normal weight patients and did not differ significantly from underweight (45.5%), overweight (36.1%) and obese (32.5%) patients. The same was true for death (9.5% vs. 14.5%, 9.6% and 7.5%) and sICH (3.9% vs. 5.5%, 4.3%, 2.7%). Neither in univariable nor in multivariable analyses did the risks of poor outcome, death or sICH differ significantly between BMI groups. BMI as a continuous variable was not associated with poor outcome, death or sICH in unadjusted [ OR (95% CI ) 0.99 (0.97–1.01), 0.98 (0.95–1.02), 0.98 (0.94–1.04)] or adjusted analyses [ OR (95% CI ) 1.01 (0.98–1.03), 0.99 (0.95–1.05), 1.01 (0.97–1.05)], respectively. Conclusion In this largest study to date, investigating the impact of BMI in IVT ‐treated stroke patients, BMI had no prognostic meaning with regard to 3‐month functional outcome, death or occurrence of sICH .