Does Obesity Influence the Outcome of the Patients Following a Cardiac Arrest?

Abstract

A bstract Background Obesity is one of the major risk factors for cardiovascular and peripheral vascular diseases. However, the obesity paradox confers survival benefits in heart failure and cardiac surgery patients. Studies examining the outcomes of obese patients following cardiac arrest provided conflicting results. Objective To study the association between obesity and outcome in patients following cardiac arrest. Materials and methods We conducted a retrospective cohort study at a tertiary intensive care unit (ICU). Data were collected from medical records between January 1, 2018 and December 31, 2018, for all adult ICU patients who were admitted to our ICU following a cardiac arrest. Data collected included demographics, anthropometrics, and details of the cardiac arrest. The primary outcome was survival to hospital discharge. Secondary outcomes were duration of mechanical ventilation, ICU, and hospital length of stay. Results A total of 126 patients were admitted to the ICU following a cardiac arrest during the study period, of whom 14 patients were excluded due to missing body mass index (BMI) data. Seventy-six patients were non-obese (BMI <30) and 36 patients were obese (BMI ≥30). There was no difference in survival to hospital discharge between obese and non-obese patients (52.8 vs 59.2%, p = 0.52, OR = 0.77, 95% CI 0.35–1.71). Moreover, there was no difference between obese and non-obese patients in ICU length of stay (81.50 vs 76.0 hours, p = 0.42), hospital length of stay (9 vs 10 days, p = 0.63), and duration of mechanical ventilation (55 vs 43 hours, p = 0.30). In the logistical regression analysis, BMI was not associated with improved survival (OR = 0.97, 95% CI 0.92–1.03, p = 0.23). Conclusion For patients admitted to ICU following cardiac arrest, we could not show that obesity improves survival, length of stay, or duration of mechanical ventilation. How to cite this article Chavda MP, Pakavakis A, Ernest D. Does Obesity Influence the Outcome of the Patients Following a Cardiac Arrest? Indian J Crit Care Med 2020;24(11):1077–1080.

Do Body Mass Index and Nutritional Risk Score 2002 Influence the In-Hospital Mortality of Patients Following Cardiac Arrest?

“…Determining its location and amount—for instance, by bioelectrical impedance analysis or DEXA (dual-energy X-ray absorptiometry)—can facilitate identification of people with a similar BMI but different CVD risk [ 29 , 30 , 31 ]. Chavda et al did not link obesity with improved in-hospital survival outcome in patients who were admitted to the ICU after CA [ 32 ]. Other researchers have proven that subpar in-hospital mortality and neurological outcomes were the concomitant occurrences among obese CA patients [ 33 ].…”

No obesity paradox in out-of-hospital cardiac arrest: Data from the Swedish registry of cardiopulmonary resuscitation

“…Even though several studies have been conducted on the topic of obesity and sudden cardiac arrest, there is yet no clear evidence and consensus whether obesity improves 7 , 8 , 9 or decreases 13 , 11 , 12 chances of survival after out-of-hospital cardiac arrests. We believe that the greatest strength of this study, compared to previous, is our large study population and that we accounted for the presence of diabetes, both type 1 and 2, among the cases included.…”

“… 7 , 8 , 9 In recent years, however, the “obesity paradox” has been challenged by several studies. 10 , 11 , 12 , 13 , 14 …”