AI Article Synopsis
- - The study explored how Body Mass Index (BMI) is related to in-hospital mortality in patients hospitalized for acute heart failure (AHF), analyzing data from over 219,000 patients across the US between 2015 and 2016.
- - Findings showed that higher BMI groups had significantly lower in-hospital mortality rates compared to underweight and normal-weight patients, with a complex non-linear relationship identified between BMI and patient outcomes.
- - The results also highlighted that BMI categories of ≤25 kg/m were independent predictors of higher mortality, along with factors like age and comorbidities, indicating a reverse J-shaped relationship between BMI and mortality rates in AHF patients.
Article Abstract
Background: The association between Body Mass Index (BMI) and clinical outcomes following acute heart failure (AHF) hospitalization is debated in the literature. Our objective was to study the real-world relationship between BMI and in-hospital mortality in patients who were admitted with AHF.
Methods: In this retrospective, multi-center study, we utilized the National Inpatient Sample (NIS) database to identify a sampled cohort of patients who were hospitalized with AHF between October 2015 and December 2016. Outcomes of interest included in-hospital mortality and length of stay (LOS). Patients were divided into 6 BMI (kg/m) subgroups according to the World Health Organization (WHO) classification: (1) underweight ≤ 19, (2) normal weight 20-25, (3) overweight 26-30, (4) obese I 31-35, (5) obese II 36-39, and (6) extremely obese ≥40. A multivariable logistic regression model was used to identify predictors of in-hospital mortality and to identify predictors of LOS.
Results: A weighted total of 219,950 hospitalizations for AHF across the US were analyzed. The mean age was 66.3 ± 31.5 years and most patients (51.8%) were male. The crude data showed a non-linear complex relationship between BMI and AHF population outcomes. Patients with elevated BMI exhibited significantly lower in-hospital mortality compared to the underweight and normal weight study participants (5.5, 5,5, 2,8, 1.6, 1.4, 1.6% in groups by BMI ≤ 19, 20-25, 26-30, 31-35, 36-39, and, ≥40 respectively, < 0.001) and shorter LOS. In the multivariable regression model, BMI subgroups of ≤ 25kg/m were found to be independent predictors of in-hospital mortality. Age and several comorbidities, and also the Deyo Comorbidity Index, were found to be independent predictors of increased mortality in the study population.
Conclusion: A reverse J-shaped relationship between BMI and mortality was documented in patients hospitalized for AHF in the recent years confirming the "obesity paradox" in the real-world setting.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9097269 | PMC |
| http://dx.doi.org/10.3389/fcvm.2022.855525 | DOI Listing |
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