H Gensicke1, A Wicht1, O Bill2, A Zini3, P Costa4, G Kägi5, R Stark5, D J Seiffge1, C Traenka1, N Peters1, L H Bonati1, G Giovannini3, G M De Marchis1, L Poli4, A Polymeris1, P Vanacker2,6, H Sarikaya7, P A Lyrer1, A Pezzini4, L Vandelli3, P Michel2, S T Engelter1,8. 1. Stroke Centre and Neurology, University Hospital Basel, Basel, Switzerland. 2. Department of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland. 3. Stroke Unit, Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Modena, Italy. 4. Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy. 5. Department of Neurology, Kantonsspital St Gallen, St Gallen, Switzerland. 6. Department of Neurology, University Hospital Antwerp, Edegem, Belgium. 7. Department of Neurology, University Hospital Berne, Berne, Switzerland. 8. Neurorehabilitation Unit, University Centre for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Basel, Switzerland.
Abstract
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/m2 ) from underweight (<18.5 kg/m2 ), overweight (25-29.9 kg/m2 ) and obese (≥30 kg/m2 ) 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.
BACKGROUND AND PURPOSE: The impact of body mass index (BMI) on outcome in strokepatients 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/m2 ) from underweight (<18.5 kg/m2 ), overweight (25-29.9 kg/m2 ) and obese (≥30 kg/m2 ) 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 strokepatients, BMI had no prognostic meaning with regard to 3-month functional outcome, death or occurrence of sICH.
Authors: S Tsetsou; M Amiguet; A Eskandari; R Meuli; P Maeder; B Jiang; M Wintermark; P Michel Journal: Neuroradiology Date: 2016-12-27 Impact factor: 2.804
Authors: Jan F Scheitz; Henrik Gensicke; Sanne M Zinkstok; Sami Curtze; Marcel Arnold; Christian Hametner; Alessandro Pezzini; Guillaume Turc; Andrea Zini; Visnja Padjen; Susanne Wegener; Annika Nordanstig; Lars Kellert; Georg Kägi; Yannick Bejot; Patrik Michel; Didier Leys; Christian H Nolte; Paul J Nederkoorn; Stefan T Engelter Journal: BMJ Open Date: 2018-09-17 Impact factor: 2.692