Artikel
The role of obesity for outcome after subarachnoid hemorrhage
Suche in Medline nach
Autoren
-
J. Platz
- Klinik und Poliklinik für Neurochirurgie, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main
-
E. Güresir
- Klinik und Poliklinik für Neurochirurgie, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main
-
V. Seifert
- Klinik und Poliklinik für Neurochirurgie, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main
-
H. Vatter
- Klinik und Poliklinik für Neurochirurgie, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main
| Veröffentlicht: | 4. Juni 2012 |
|---|
Gliederung
Text
Objective: Obesity is a risk factor for cardiovascular disease associated with poor outcome. Recent studies described an improved outcome of obese patients in ischemic heart disease or stroke, a phenomenon called “obesity paradox”, We assessed the impact of BMI on outcome after subarachnoid hemorrhage (SAH).
Methods: We retrospectively analyzed the data of 741 patients. A body mass index (BMI) > 25 kg/m2 was considered overweight and a BMI > 30 kg/m2 as obese. Outcome according to the Glasgow Outcome scale (GOS) at discharge and after 6 months was assessed using logistic regression analysis.
Results: Of 741 patients, 381 (51.4%) were classified as overweight, 75 of these were categorized as obese. Of all overweight patients, 53.0% achieved a favorable outcome (GOS > 3). In contrast, 61.4% of the 360 patients with a normal BMI had a favorable outcome (P = 0.021). However, in the multivariate analysis, only age (OR 1.051, 95% CI 1.04–1.07, P < 0.001) and WFNS grade (OR 2.095, 95% CI 1.87–2.35, P < 0.001) were independent predictors for outcome after 6 months. Selecting only poor grade patients (WFNS > 3, n = 321), 171 (53.3%) were overweight with 21.6% attaining a favorable outcome, compared to 35.3% of the 150 normal weight patients (P = 0.006). Yet again, in the multivariate analysis for this subgroup, age was the only independent predictor for outcome (OR 1.047, 95% CI 1.027–1.067, P < 0.001).
Conclusions: Although many physicians anticipate a worse outcome for obese patients, in our study BMI was not an independent predictor for outcome. The impact of obesity seems less important for outcome after SAH compared to the impact of SAH itself and the age of the patient.
