Abstract 105: Obesity Paradox in Patients with Non-Hemorrhagic Stroke

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Background: Obesity is associated with improved outcomes in patients with congestive heart failure and/or coronary artery disease; the obesity paradox. Effects of obesity on mortality in non-hemorrhagic stroke patients have not been well investigated.

Material and Methods: Retrospective chart review was performed in 146 consecutive patients treated for non-hemorrhagic stroke at a single academic medical center. Patients were divided in to 4 groups according to their BMI: Group I with BMI (0-18.5 kg/m2)-4 patients (3%) Group II BMI (18.6-25 kg/m2)-51 patients (35%), Group III BMI (26-30 kg/m2)-46 patients (32%), and Group IV BMI (31+)-45 patients (31%). Long-term outcomes were ascertained through the National Death Index. This study was approved by the institutional IRB.

Results: Prevalence of CAD, female gender, hypertension, atrial fibrillation, hyperlipidemia, PVD and chronic kidney disease were similar between BMI groups.

Overweight patients with non-hemorrhagic stroke were younger, with an increased incidence of diabetes (4% in Group II, 25% in Group III, and 37% in Group IV, p<0.0016). There was a trend of increased prevalence of hypertension in overweight patients with non-hemorrhagic stroke (51% in Group II, 55% in Group III, and 70% in Group IV, p=0.3146).

Lower BMI was associated with increased short-term mortality (52% in Group II, 33% in Group III and 12% in Group IV, p <0.004). Despite improved short term mortality, the overall longevity in obese stroke patients were significantly reduced, as compared to patients with normal weight. Average age at time of death was 86+/- 9.6 years old in Group II patients, 76 +/- 15 years old in Group III, and 76 +/- 9.8 years old in Group IV patients, p<0.003 for Group III vs. II and p<0.001 in Group IV vs. II)

Conclusions: Obese patients present with non-hemorrhagic stroke at a younger age. Despite short term improved outcomes, obesity is not associated with improved overall longevity.

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