Purpos: The role of body mass index (BMI) on clinical outcomes in patients resuscitated from cardiac arrest has drawn attention recently. However, influence of obesity on clinical outcomes of patients underwent cardiac arrest is still controversial.
Methods: The retrospective cohort study recruited 273 non-traumatic adult cardiac arrest survivors who received emergent coronary angiography (CAG) after return of spontaneous circulation (ROSC) in three hospitals from January 2011 to September 2017. The enrolled patients were divided into the underweight, normal, overweight and obese groups based on BMI (underweight: BMI < 18.5; normal: 18.5-24.9; overweight: 25.0-29.9; obese≥30). The inhospital mortality and poor neurological outcome were compared between different BMI groups respectively.
Results: There were 13 (4.8%) patients in the under-weight group, 121 (44.3%) patients in the normal-weight group, 100 (36.6%) patients in the over-weight group and 39 (14.3%) patients in the obese group. The obese group had significantly higher rates of inhospital mortality and poor neurological outcome (cerebral performance scale=3~5) as compared to the other 3 groups (inhospital mortality: underweight 38.5%, normal: 29.8%, overweight: 39.0%, obese: 64.1%, p=0.002; poor neurological outcome: underweight 53.9%, normal: 43.8%, over-weight: 47.0%, obese: 71.8%, p = 0.02). Compared with the normal weight group, the obese group presented with higher risk for inhospital mortality and poor neurological outcome (inhospital mortality: adjusted OR=5.24, 95% CI 2.30–11.92, p <0.001; poor neurological outcome: adjusted OR=3.84, 95% CI 1.68–8.78, p = 0.001).
Conclusion: In patients resuscitated from cardiac arrest, the obese BMI was associated with increased risk for inhospital mortality and poor neurological recovery.