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Abstract
Background: The paradoxical phenomenon of relative longevity among obese patients with established diseases has been reported for various disease conditions. The authors sought to investigate whether the obesity paradox also applies to intracerebral hemorrhage (ICH) survivors.
Methods: A total of 1,604 patients with ICH from 33 centers with nationwide coverage were prospectively enrolled to this cohort between October 2002 and March 2004. Baseline information including body mass index (BMI) was collected at admission, and mortality status was ascertained from the governmental mortality archive on December 2006. Associations between obesity and 30-day mortality or long-term risk of death were analyzed.
Results: Among the 1,356 patients with ICH included, the 30-day mortality rate was 7.2% and the long-term mortality rate was 26.9% after a mean follow-up of 33.6 ± 15.5 months. Neither BMI nor obesity status were associated with 30-day mortality after ICH. However, BMI was independently associated with a lower risk of long-term mortality (hazard ratio [HR] 0.91 per 1-kg/m2 increase; 95% confidence interval [CI] 0.87–0.95). As compared with patients of normal weight, underweight subjects had a higher risk of death (HR 1.64; 95% CI 1.11–2.40), and conversely, overweight (HR 0.69; 95% CI 0.49–0.96) or obese (HR 0.61; 95% CI 0.43–0.88) subjects showed a lower risk of post-ICH death.
Conclusion: In our study, obesity was associated with a lower risk of long-term death but not with 30-day mortality after ICH. Thus, it may be considered that an obesity status in a patient with ICH be treated as an indication of metabolic reservoir capacity and an increased likelihood of survival.
Footnotes
Study funding: Supported by the Korean Food and Drug Administration (KFDA)and the Korean Health 21 R&D Project, Ministry of Health and Welfare, Republic of Korea (A060171, A080503, and A090529). The analyses and interpretations of the data and the final content of the article were produced independent of the financial sponsors. The ABBA study was supported by the KFDA, but the KFDA has no role in the analysis of ABBA-ICH cohort.
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- ABBA-ICH
- Acute Brain Bleeding Analysis–IntraCerebral Hemorrhage
- BMI
- body mass index
- CI
- confidence interval
- GCS
- Glasgow Coma Scale
- HR
- hazard ratio
- ICH
- intracerebral hemorrhage
- KNDC
- Korean National Death Certificate.
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Supplemental data at www.neurology.org
- Received June 27, 2010.
- Accepted October 18, 2010.
- Copyright © 2011 by AAN Enterprises, Inc.
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