Sotirios Kakavas1, Georgios Georgiopoulos2, Dimitrios Oikonomou3, Dimitrios Karayiannis4, Stefano Masi5, Georgios Karlis6, Theodoros Xanthos7. 1. National and Kapodistrian University of Athens, Medical School, "Evaggelismos"Hospital, 1st Department of Intensive Care, Athens, Greece; Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece. Electronic address: sotikaka@yahoo.com. 2. 1st Cardiology Department, National and Kapodistrian University of Athens, University Medical School, Hippokration Hospital, Greece. 3. "Evaggelismos"Hospital, Cardiology Department, Athens, Greece. 4. "Evaggelismos"Hospital, Department of Clinical Nutrition, Athens, Greece. 5. National Centre for Cardiovascular Prevention and Outcomes, Institute of Cardiovascular Science, UCL, London, UK. 6. National and Kapodistrian University of Athens, Medical School, "Evaggelismos"Hospital, 1st Department of Intensive Care, Athens, Greece; Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece. 7. Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece; European University Cyprus, School of Medicine, Nicosia, Cyprus.
Abstract
BACKGROUND: Observational studies examining the association between body mass index (BMI) and the outcome of cardiac arrest (CA) shows controversial results. METHODS: We reviewed literature for studies assessing the impact of BMI on survival and neurological outcome following CA. Eligible studies were subsequently meta-analyzed and pooled odds ratios and their corresponding 95% confidence intervals for post CA survival and neurological status were derived. RESULTS: A total of 7 studies with 24,651 patients were evaluable for this meta-analysis. The studies were also categorized by location of the CA and the use of therapeutic hypothermia. Our results suggested that BMI between 25 and 29.9 kgr/m2 had a favorable impact on survival after CA (OR = 1.172, 95% CI, 1.109-1.236) in comparison to normal weight subjects. Likewise, overweight patients presented increased odds for a favorable neurological outcome after CA (OR = 1.112, 95% CI, 1.020-1.213). On the contrary, underweight subjects presented decreased odds of surviving after CA as compared to normal BMI subjects (OR = 0.781, 95% CI, 0.652-0.935). Finally, BMI >30 kgr/m2 was not associated with improved survival or neurological outcome as compared to BMI 18.5-24.9 kgr/m2. CONCLUSIONS: Overweight patients have a favorable prognosis after CA in terms of both survival and neurological outcome. This effect was amplified when the analysis is restricted in in-hospital cardiac arrest and in patients non-treated with therapeutic hypothermia.
BACKGROUND: Observational studies examining the association between body mass index (BMI) and the outcome of cardiac arrest (CA) shows controversial results. METHODS: We reviewed literature for studies assessing the impact of BMI on survival and neurological outcome following CA. Eligible studies were subsequently meta-analyzed and pooled odds ratios and their corresponding 95% confidence intervals for post CA survival and neurological status were derived. RESULTS: A total of 7 studies with 24,651 patients were evaluable for this meta-analysis. The studies were also categorized by location of the CA and the use of therapeutic hypothermia. Our results suggested that BMI between 25 and 29.9 kgr/m2 had a favorable impact on survival after CA (OR = 1.172, 95% CI, 1.109-1.236) in comparison to normal weight subjects. Likewise, overweight patients presented increased odds for a favorable neurological outcome after CA (OR = 1.112, 95% CI, 1.020-1.213). On the contrary, underweight subjects presented decreased odds of surviving after CA as compared to normal BMI subjects (OR = 0.781, 95% CI, 0.652-0.935). Finally, BMI >30 kgr/m2 was not associated with improved survival or neurological outcome as compared to BMI 18.5-24.9 kgr/m2. CONCLUSIONS: Overweight patients have a favorable prognosis after CA in terms of both survival and neurological outcome. This effect was amplified when the analysis is restricted in in-hospital cardiac arrest and in patients non-treated with therapeutic hypothermia.
Authors: Carsten Lott; Anatolij Truhlář; Anette Alfonzo; Alessandro Barelli; Violeta González-Salvado; Jochen Hinkelbein; Jerry P Nolan; Peter Paal; Gavin D Perkins; Karl-Christian Thies; Joyce Yeung; David A Zideman; Jasmeet Soar Journal: Notf Rett Med Date: 2021-06-10 Impact factor: 0.826
Authors: Gene Yong-Kwang Ong; Aloysius Jian Feng Ang; Zhao Jin Chen; Yiong Huak Chan; Phua Hwee Tang; Elisabeth Sue Sheun Fong; Jun Yuan Tan; AmirZeb S O Aurangzeb; Jen Heng Pek; Ian Maconochie; Kee Chong Ng; Vinay Nadkarni Journal: Resusc Plus Date: 2022-01-20