Obesity is associated with better survival and functional outcome after acute intracerebral hemorrhage.

Objective: To evaluate the association of obesity measured by body mass index (BMI) with mortality and functional outcome in patients with acute intracerebral hemorrhage (ICH).

Methods: Data were from 1571 patients with ICH enrolled in a national, multi-centre, prospective, hospital-based register: the ChinaQUEST (Quality Evaluation of Stroke Care and Treatment) study. The outcomes included all-cause mortality at 12months, and death or high dependency at 3 and 12months. High dependency was defined as a modified Rankin Scale score of 3-5.

Results: Of 1571 patients with ICH, 109 were underweight (BMI<18.5kg/m), 657 were normal-weight (BMI 18.5-23kg/m), 341 were overweight (BMI 23-25kg/m) and 464 were obese (BMI≥25kg/m). Compared with normal-weight patients, obese patients had significantly decreased risks of death at 12months (HR: 0.71, 95% CI: 0.56-0.91) and death or high dependency at 3 and 12months (OR: 0.71, 95% CI: 0.53-0.95; OR: 0.69, 95% CI: 0.51-0.94) after adjusting for baseline characteristics. Neither underweight nor overweight was associated with these three outcomes significantly.

Conclusions: In patients with acute ICH, being obese is associated with a decreased mortality and better functional recovery. Further interventional studies are needed to guide the weight management strategy for patients with ICH.