Association between the body mass index and outcomes of patients resuscitated from out-of-hospital cardiac arrest: a prospective multicentre registry study

Abstract

Background The effects of the body mass index (BMI) on outcomes of patients resuscitated from cardiac arrest are controversial. Therefore, the current study investigated the association between the BMI and the favourable neurologic outcomes and survival to discharge of patients resuscitated from out-of-hospital cardiac arrest (OHCA). Methods This multicentre, prospective, nationwide OHCA registry-based study was conducted using data from the Korean Cardiac Arrest Resuscitation Consortium (KoCARC). We enrolled hospitals willing to collect patient height and weight and included patients who survived to the hospital between October 2015 and June 2018. The included patients were categorised into the underweight (< 18.5 kg/m2), normal weight (≥18.5 to < 25 kg/m2), overweight (≥25 to < 30 kg/m2), and obese groups (≥30 kg/m2) according to the BMI per the World Health Organization (WHO) criteria. The primary outcome was a favourable neurologic outcome; the secondary outcome was survival to discharge. Univariate and multivariate analyses were performed to investigate the association between BMI and outcomes. Results Nine hospitals were enrolled; finally, 605 patients were included in our analysis and categorised per the WHO BMI classification. Favourable neurologic outcomes were less frequent in the underweight BMI group than in the other groups (p = 0.002); survival to discharge was not significantly different among the BMI groups (p = 0.110). However, the BMI classification was not associated with favourable neurologic outcomes or survival to discharge after adjustment in the multivariate model. Conclusion The BMI was not independently associated with favourable neurologic and survival outcomes of patients surviving from OHCA.

Barriers and facilitators to cardiopulmonary resuscitation within pre-hospital emergency medical services: a qualitative study

“…However, no study was found to investigate the effect of the patient's place of living on the cardiopulmonary resuscitation. Another study showed that the body mass index is not independently associated with the patient's survival rate [31]. This quantitative study investigated the output of the cardiopulmonary resuscitation, and its setting and research method are different from the current study.…”

Association between Body Mass Index and Outcomes in Patients with Return of Spontaneous Circulation after Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis

“…Malnutrition and baseline comorbidities, which can cause a patient to be underweight, may increase the risk of poor outcomes. Additionally, underweight cardiac arrest patients less frequently showed cardiogenic arrest with shockable rhythms, which is a good prognostic factor for the etiology of cardiac arrest [13,17].…”

“…After reviewing the full-text articles more thoroughly, we excluded 43 studies for irrelevant population (n = 25), irrelevant outcome measure (n = 12), irrelevant control group (n = 4), and meta-analyses (n = 2). The six remaining studies with 2427 patients were included in the meta-analysis [13,17,18,[25][26][27]. The reference management software, Endnote X9 (Clarivate Analytics, Philadelphia, United States), was used for all identified studies in the literature search.…”

“…After reviewing the full-text articles more thoroughly, we excluded 43 studies for irrelevant population (n = 25), irrelevant outcome measure (n = 12), irrelevant control group (n = 4), and meta-analyses (n = 2). The six remaining studies with 2427 patients were included in the meta-analysis [13,17,18,[25][26][27].…”

“…However, previous meta-analysis studies have various errors in data collection and meta-analysis procedures; for example, in one study, both IHCA and OHCA patients were recruited for subgroup analysis, the included population had different inclusion criteria, and the association between underweight status and outcomes in OHCA patients was not presented [15]. Moreover, several studies comparing the outcomes between BMI categories in OHCA patients have been reported recently [17,18].…”