Prevalence, trends, and outcomes of metabolically healthy obesity or overweight in stroke hospitalizations of elderly patients: A 2016-2019 US population analysis.

Introduction: Obesity and overweight have been associated with an increase in the risk of stroke and poor outcomes. Meanwhile, Metabolically healthy obesity and overweight (MHOO) trends are understudied in association with stroke. This study aims to analyze the MHO trends and outcomes concerning stroke.

Methods: We queried the National Inpatient Sample (2016-2019) to identify stroke hospitalizations in the metabolically healthy (MH) elderly population (≥ 65 years) with vs. without obesity or overweight (OO) by using ICD-10 codes after excluding patients with hypertension, hyperlipidemia, and type 2 diabetes mellitus. Trends, demographics, comorbidities, and outcomes were then compared between the MHOO+vs and MHOO-ve cohorts.

Results: From 2016 to 2019, 7,242,846 hospitalizations were identified over age ≥ 65. Prevalence of stroke was higher in the MHOO-ve cohort (2.4 % vs 1.4 % p < 0.001). The MHOO-ve cohort was older (78 vs. 73 years), had a higher male presence (48.2 % vs. 36.4 %), Hispanics (5.1 % vs. 4.7 %), Whites (83.8 % vs. 82.3 %), and Asians (2.4 % vs. 1.1 %). The all-cause death rate (15.9 % vs. 14.4 %) and home health care (16.6 % vs 12.4 %) were also higher in the MHOO-ve cohort. Regression analysis adjusted for confounders showed no significant association between Stroke and OO in the cohorts.

Conclusion: After excluding major cardiovascular risk factors, obesity and overweight were not significant independent predictors of in-hospital mortality in metabolically healthy elderly stroke patients. Further research is needed to explore other factors influencing this relationship.