Impact of body mass index on outcome in stroke patients treated with intravenous thrombolysis

Eur J Neurol. 2016 Dec;23(12):1705-1712. doi: 10.1111/ene.13071. Epub 2016 Aug 1.

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.

Keywords: body mass index; intravenous thrombolysis; outcome; stroke; symptomatic intracranial haemorrhage.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Body Mass Index*
  • Brain Ischemia / drug therapy*
  • Female
  • Humans
  • Infusions, Intravenous
  • Intracranial Hemorrhages / etiology
  • Male
  • Middle Aged
  • Prognosis
  • Risk
  • Stroke / drug therapy*
  • Thrombolytic Therapy / adverse effects*
  • Treatment Outcome