Obesity worsens survival, neurological outcomes in cardiogenic arrest

Obesity is associated with worse outcomes in cardiogenic arrest survivors with significant coronary artery disease, a recent study has shown.

Researchers conducted a multicentre retrospective investigation of 201 patients (mean age, 61.84±12.74 years; 83.08 percent male) who had undergone emergency coronary angiography. Participants were categorized into four body mass index (BMI) categories: underweight (<18.5 kg/m²), normal weight (18.5–24.9 kg/m²), overweight (25.0–29.9 kg/m²), and obese (≥30 kg/m²). In-hospital mortality and neurological outcomes were compared among groups.

Majority of the patients who were obese (72.7 percent) did not survive until discharge. In comparison, less than half of the underweight (44.4 percent), normal weight (35.6 percent), and overweight (47.2 percent) groups died during hospitalization.

Adjusting for confounders, the researchers found through Cox proportional hazards analysis that the risk of in-hospital mortality was significantly elevated in obese patients, as compared with their normal weight comparators (adjusted hazard ratio, 4.27, 95 percent confidence interval [CI], 1.87–12.04; p=0.008).

The same was true for the risk of unsatisfactory neurological outcomes, assessed by attending physicians using Glasgow-Pittsburgh Cerebral Performance Category scores (adjusted odds ratio, 3.33, 95 percent CI, 1.42–8.78; p=0.009). This endpoint occurred much more frequently in obese vs underweight, normal weight, and overweight patients (75.8 percent vs 55.6 percent, 47.1 percent, and 55.6 percent, respectively).

The effect of obesity on the outcomes remained robust even after subgroup analyses according to age, sex, pre-existing diseases, cardiopulmonary resuscitation, or post-resuscitation care.