Paradoxical longevity in obese patients with intracerebral hemorrhage

B. J. Kim, S. H. Lee, W. S. Ryu, Chi Kyung Kim, Juneyoung Lee, B. W. Yoon

Research output: Contribution to journalArticle

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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/m 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.

Original languageEnglish
Pages (from-to)567-573
Number of pages7
JournalNeurology
Volume76
Issue number6
DOIs
Publication statusPublished - 2011 Feb 8

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Cerebral Hemorrhage
Mortality
Obesity
Confidence Intervals
Body Mass Index
Thinness
Survivors
Weights and Measures
Survival

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Paradoxical longevity in obese patients with intracerebral hemorrhage. / Kim, B. J.; Lee, S. H.; Ryu, W. S.; Kim, Chi Kyung; Lee, Juneyoung; Yoon, B. W.

In: Neurology, Vol. 76, No. 6, 08.02.2011, p. 567-573.

Research output: Contribution to journalArticle

Kim, B. J. ; Lee, S. H. ; Ryu, W. S. ; Kim, Chi Kyung ; Lee, Juneyoung ; Yoon, B. W. / Paradoxical longevity in obese patients with intracerebral hemorrhage. In: Neurology. 2011 ; Vol. 76, No. 6. pp. 567-573.
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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/m 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.",
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AB - 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/m 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.

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