Document Detail


Association between obesity and mortality after acute first-ever stroke: the obesity-stroke paradox.
MedLine Citation:
PMID:  21127299     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: limited data exist concerning obesity and survival in patients after acute stroke. The objective of this study was to investigate the association between obesity and survival in patients with acute first-ever stroke.
METHODS: patients were prospectively investigated based on a standard diagnostic protocol over a period of 16 years. Evaluation was performed on admission, at 7 days, at 1, 3, and 6 months after discharge, and yearly thereafter for up to 10 years after stroke. The study patients were divided into 3 groups according to body mass index (BMI): normal weight (<25 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (≥ 30 kg/m(2)). Overall survival during follow-up was the primary end point. The secondary end point was the overall composite cardiovascular events over the study period.
RESULTS: based on our inclusion criteria, 2785 patients were recruited. According to BMI, 1138 (40.9%) patients were of normal weight, 1113 (41.0%) were overweight, and 504 (18.1%) were obese. NIHSS score on admission (mean, 11.28 ± 8.65) was not different among the study groups. Early (first week) survival in obese (96.4%; 95% CI, 94.8%-97.9%) and overweight patients (92.8%; 95% CI, 91.2%-94.4%) was significantly higher compared to that of normal-weight patients (90.2%; 95% CI, 88.4%-92.0%). Similarly, 10-year survival was 52.5% (95% CI, 46.4%-58.6%) in obese, 47.4% (95% CI, 43.5%-51.3%) in overweight, and 41.5% (95% CI, 39.7%-45.0%) in normal-weight patients (log-rank test=17.7; P<0.0001). Overweight (HR, 0.82; 95% CI, 0.71-0.94) and obese patients (HR, 0.71; 95% CI, 0.59-0.86) had a significantly lower risk of 10-year mortality compared to normal-weight patients after adjusting for all confounding variables.
CONCLUSIONS: based on BMI estimation, obese and overweight stroke patients have significantly better early and long-term survival rates compared to those with normal BMI.
Authors:
Konstantinos Vemmos; George Ntaios; Konstantinos Spengos; Paraskevi Savvari; Anastasia Vemmou; Theodora Pappa; Efstathios Manios; George Georgiopoulos; Maria Alevizaki
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-12-02
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  42     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-28     Completed Date:  2011-01-28     Revised Date:  2011-07-18    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  30-6     Citation Subset:  IM    
Affiliation:
Acute Stroke Unit, Alexandra Hospital, Athens, Greece.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Aged, 80 and over
Body Mass Index
Body Weight
Female
Follow-Up Studies
Humans
Male
Middle Aged
Obesity / complications,  mortality*
Retrospective Studies
Stroke / complications,  mortality*
Survival Rate
Comments/Corrections
Comment In:
Stroke. 2011 Jun;42(6):e395; author reply e396   [PMID:  21546473 ]
Stroke. 2011 May;42(5):e379; author reply e380   [PMID:  21441146 ]

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