Introduction: Obesity is increasing world-wide. Evidence shows stroke patients with higher body-mass index (BMI) have better survival outcomes than those with lower BMI. The evidence is conflicting regarding BMI and complications and outcomes in aneurysmal subarachnoid hemorrhage (aSAH).
Methods: Records of a prospective series of 283 aSAH patients from 2002-2011 were reviewed for demographics; BMI (kg/m2); medical comorbidities; GCS,WFNS, and mFS at presentation; delayed cerebral ischemia (DCI), symptomatic vasospasm (SV), and radiographic infarct (RI); and Glascow Outcome Scores (GOS) at 3 months or greater. The population was separated into the following BMI categories: group 1, <25 kg/m2; group 2, 25-<30 kg/m2; and group 3, >30 kg/m2. Statistical analysis comparing comorbidities and characteristics of aSAH between groups included t-tests and Chi-squared tests. Odds ratios were used to compare the risk of DVI, SV, and RI and GOS. Univariate and multivariate logistic regression with odds ratios (OR) and confidence intervals (CI) analyzed BMI as a continuous variable.
Results: Group 1 had 93 patients with an average BMI of 22.4±1.8, group 2 had 101 patients with an average BMI of 27.6±1.4, and group 3 had 89 patients with an average BMI of 35.7±4.6 (p<0.05 between groups). Regarding comorbidities and aSAH presentation and treatment, the only difference was a greater prevalence of hypertension, diabetes mellitus, and clipping in group 3 compared with group 1 (Table 1). There was no significant association between BMI group and DCI, SV, RI, or GOS (Table 2). Neither univariate nor multivariate logistic regression analyses (including age, WFNS, modified Fisher score, and BMI) showed any significant relationship between BMI and DCI, SV, RI, or GOS. BMI was not associated with any of the outcome measures in analysis adjusted for modality of aneurysm treatment.
Conclusions: In our cohort, BMI did not influence the likelihood of delayed ischemia or alter functional outcomes after aSAH.
Patient Care: By showing that obese patients do not have worse outcomes after subarachnoid hemorrhage
Learning Objectives: By the conclusion of this session, participants should be able to: 1. Better understand the effect of BMI with complications and outcomes in subarachnoid hemorrhage
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