Body mass index and survival after in-hospital cardiac arrest.
Body mass index and survival after in-hospital cardiac arrest.
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DOI：
10.1161/circoutcomes.109.912501
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发表时间：
2010-09
期刊：
影响因子：
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通讯作者：
American Heart Association National Registry of Cardiopulmonary Resuscitation (NRCPR) investigators
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文献类型：
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作者：
Jain R;Nallamothu BK;Chan PS;American Heart Association National Registry of Cardiopulmonary Resuscitation (NRCPR) investigators
The quality and effectiveness of resuscitation processes may be influenced by patients' body mass index (BMI); however, the relationship between BMI and survival after in-hospital cardiac arrest has not been previously studied. We evaluated 21,237 adult patients with an in-hospital cardiac arrest within the National Registry for Cardiopulmonary Resuscitation (NRCPR). We examined the association between BMI (classified as underweight [<18.5 kg/m2], normal [18.5-24.9], overweight [25.0-29.9], obese [30.0-34.9], and very obese [≥35.0]) and survival to hospital discharge using multivariable logistic regression, after stratifying arrests by rhythm type and adjusting for patient characteristics. Of 4,499 patients with ventricular fibrillation or pulseless ventricular tachycardia as initial rhythm, 1,825 (40.6%) survived to discharge. After multivariable adjustment, compared with overweight patients, underweight (Odds Ratio [OR], 0.59 [95% CI: 0.41-0.84]; p=0.003), normal weight (OR, 0.75; [0.63-0.89]; p<.001), and very obese (OR, 0.78 [0.63-0.96]; p=0.02) had lower rates of survival, while obese patients had similar rates of survival (OR, 0.87; 95% CI, 0.72-1.06; p=0.17). In contrast, of 16,738 patients with arrests due to asystole or pulse less electrical activity, only 2,501 (14.9%) survived. After multivariable adjustment, all BMI groups had similar rates of survival except underweight patients (OR, 0.67 [0.54-0.82]; p<.001). For cardiac arrests due to shockable rhythms, underweight, normal weight, and very obese patients had lower rates of survival to discharge. In contrast, for cardiac arrests due to non-shockable rhythms, survival to discharge was similar across BMI groups, except for underweight patients. Future studies are needed to clarify the extent to which BMI affects the quality and effectiveness of resuscitation measures.
