Guillaume Geri1, Guillaume Savary2, Stéphane Legriel2, Florence Dumas3, Sybille Merceron2, Olivier Varenne4, Bernard Livarek5, Olivier Richard6, Jean-Paul Mira7, Jean-Pierre Bedos2, Jean-Philippe Empana8, Alain Cariou1, David Grimaldi9. 1. Medical Intensive Care Unit, Cochin Hospital, Assistance Publique Hôpitaux de Paris, France; Paris Descartes University, France; Sudden Death Expertise Center, Paris Cardiovascular Research Centre, INSERM U970, France. 2. Intensive Care Unit, CH Versailles, Le Chesnay (78), France. 3. Paris Descartes University, France; Sudden Death Expertise Center, Paris Cardiovascular Research Centre, INSERM U970, France; Emergency Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, France. 4. Paris Descartes University, France; Cardiology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, France. 5. Cardiology Department, CH Versailles, Le Chesnay (78), France. 6. Service d'Aide Médicale Urgente (SAMU 78) Department, CH Versailles, Le Chesnay (78), France. 7. Medical Intensive Care Unit, Cochin Hospital, Assistance Publique Hôpitaux de Paris, France; Paris Descartes University, France. 8. Sudden Death Expertise Center, Paris Cardiovascular Research Centre, INSERM U970, France. 9. Intensive Care Unit, CH Versailles, Le Chesnay (78), France. Electronic address: david.grimaldi@erasme.ulb.ac.be.
Abstract
BACKGROUND: Obesity prevalence has dramatically increased over recent years and is associated with cardiovascular diseases, but data are lacking on its prognostic impact in out-of-hospital cardiac arrest (OHCA) patients. METHODS: Data of all consecutive OHCA patients admitted in two cardiac arrest centers from Paris and suburbs between 2005 and 2012 were prospectively collected. Patients treated by therapeutic hypothermia (TH) were included in the analysis. Logistic and Cox regression analyses were used to quantify the association between body mass index (BMI) at hospital admission and day-30 and 1-year mortality respectively. RESULTS: 818 patients were included in the study (median age 60.9 [50.8-72.7] year, 70.2% male). Obese patients (BMI>30kgm-2) were older, more frequently male and evidenced more frequently cardiovascular risk factors than normally (18.5<BMI<25kgm-2) or overweight patients (25<BMI<30kgm-2). Post-resuscitation shock and therapeutic hypothermia failure were more frequent in obese patients. Overall mortality at day-30 and one-year was 63.8 and 67.2%, respectively. After multivariate adjustment, BMI>30kgm-2 was independently associated with day-30 mortality (Odds ratio [OR] in comparison with normally weight patients 2.45; 95% confidence interval [95%CI: 1.32-4.56; p<0.01]). Obesity was not associated with one-year mortality (Hazard ratio [HR] 0.99, 95%CI 0.21,4.67; p=0.99) while underweight was associated with one-year mortality in this subgroup of patients (Hazard ratio [HR] 3.94, 95%CI 1.11,14.01; p=0.03). CONCLUSION: In the present study, obesity was independently associated with day-30 mortality in successfully resuscitated ICU TH OHCA patients. Further studies are needed to understand the mechanisms that underpin this finding. Copyright Â
BACKGROUND:Obesity prevalence has dramatically increased over recent years and is associated with cardiovascular diseases, but data are lacking on its prognostic impact in out-of-hospital cardiac arrest (OHCA) patients. METHODS: Data of all consecutive OHCA patients admitted in two cardiac arrest centers from Paris and suburbs between 2005 and 2012 were prospectively collected. Patients treated by therapeutic hypothermia (TH) were included in the analysis. Logistic and Cox regression analyses were used to quantify the association between body mass index (BMI) at hospital admission and day-30 and 1-year mortality respectively. RESULTS: 818 patients were included in the study (median age 60.9 [50.8-72.7] year, 70.2% male). Obesepatients (BMI>30kgm-2) were older, more frequently male and evidenced more frequently cardiovascular risk factors than normally (18.5<BMI<25kgm-2) or overweight patients (25<BMI<30kgm-2). Post-resuscitation shock and therapeutic hypothermia failure were more frequent in obesepatients. Overall mortality at day-30 and one-year was 63.8 and 67.2%, respectively. After multivariate adjustment, BMI>30kgm-2 was independently associated with day-30 mortality (Odds ratio [OR] in comparison with normally weight patients 2.45; 95% confidence interval [95%CI: 1.32-4.56; p<0.01]). Obesity was not associated with one-year mortality (Hazard ratio [HR] 0.99, 95%CI 0.21,4.67; p=0.99) while underweight was associated with one-year mortality in this subgroup of patients (Hazard ratio [HR] 3.94, 95%CI 1.11,14.01; p=0.03). CONCLUSION: In the present study, obesity was independently associated with day-30 mortality in successfully resuscitated ICU TH OHCA patients. Further studies are needed to understand the mechanisms that underpin this finding. Copyright Â
Authors: Eunmi Gil; Soo Jin Na; Jeong-Am Ryu; Dae-Sang Lee; Chi Ryang Chung; Yang Hyun Cho; Kyeongman Jeon; Kiick Sung; Gee Young Suh; Jeong Hoon Yang Journal: PLoS One Date: 2017-04-19 Impact factor: 3.240
Authors: Guy Rozen; Gabby Elbaz-Greener; Ibrahim Marai; E Kevin Heist; Jeremy N Ruskin; Shemy Carasso; Edo Y Birati; Offer Amir Journal: Clin Cardiol Date: 2021-11-16 Impact factor: 2.882