Body mass index and clinical outcomes in patients after ischaemic stroke in South Korea: A retrospective cohort study

Heekyoung Choi, Hyo Suk Nam, Euna Han

Research output: Contribution to journalArticle

Abstract

Objectives Although obesity is a risk factor for stroke, its impact on mortality in patients with stroke remains unclear. In this study, we aimed to evaluate the relationship between body mass index (BMI) and mortality due to ischaemic stroke among adults aged 20 years and above in Korea. Design Retrospective cohort study. Setting A tertiary-hospital-based stroke registry linked to the death records. Participants 3599 patients admitted for ischaemic stroke from January 2007 to June 2013. Outcome measures The HRs for all-cause and stroke-related mortality were calculated using Cox proportional hazards models. Progression from stroke-related mortality was assessed using the Fine-Grey competing risk model, treating other-cause mortality as a competing risk. Adjustments were made for age, gender, smoking status, Charlson comorbidity index, cardiovascular or non-cardiovascular comorbidities, stroke severity, severity related to other medical conditions, complications and enrolment year. We repeated the analysis with stratification based on age groups (less than 65 vs 65 years and above). Results For stroke-related mortality, there was no significant difference among the four BMI groups. The risk of all-cause mortality was 36% higher in the underweight group than in the normal weight group (long-term HR=1.36, 95% CI: 1.04 to 1.79), whereas the mortality risk of the obese group was significantly lower (HR=0.66, 95% CI: 0.54 to 0.81). Although this relationship was not estimated in the younger group, it was found that obesity had a protective effect on the all-cause mortality in the elderly (long-term HR=0.66, 95% CI: 0.52 to 0.83). Conclusions Obesity is more likely to reduce mortality risk than normal weight, especially in elderly patients.

Original languageEnglish
Article numbere028880
JournalBMJ open
Volume9
Issue number8
DOIs
Publication statusPublished - 2019 Aug 1

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Republic of Korea
Body Mass Index
Cohort Studies
Retrospective Studies
Stroke
Mortality
Obesity
Comorbidity
Social Adjustment
Weights and Measures
Death Certificates
Thinness
Korea
Proportional Hazards Models
Tertiary Care Centers
Registries
Age Groups
Smoking
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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title = "Body mass index and clinical outcomes in patients after ischaemic stroke in South Korea: A retrospective cohort study",
abstract = "Objectives Although obesity is a risk factor for stroke, its impact on mortality in patients with stroke remains unclear. In this study, we aimed to evaluate the relationship between body mass index (BMI) and mortality due to ischaemic stroke among adults aged 20 years and above in Korea. Design Retrospective cohort study. Setting A tertiary-hospital-based stroke registry linked to the death records. Participants 3599 patients admitted for ischaemic stroke from January 2007 to June 2013. Outcome measures The HRs for all-cause and stroke-related mortality were calculated using Cox proportional hazards models. Progression from stroke-related mortality was assessed using the Fine-Grey competing risk model, treating other-cause mortality as a competing risk. Adjustments were made for age, gender, smoking status, Charlson comorbidity index, cardiovascular or non-cardiovascular comorbidities, stroke severity, severity related to other medical conditions, complications and enrolment year. We repeated the analysis with stratification based on age groups (less than 65 vs 65 years and above). Results For stroke-related mortality, there was no significant difference among the four BMI groups. The risk of all-cause mortality was 36{\%} higher in the underweight group than in the normal weight group (long-term HR=1.36, 95{\%} CI: 1.04 to 1.79), whereas the mortality risk of the obese group was significantly lower (HR=0.66, 95{\%} CI: 0.54 to 0.81). Although this relationship was not estimated in the younger group, it was found that obesity had a protective effect on the all-cause mortality in the elderly (long-term HR=0.66, 95{\%} CI: 0.52 to 0.83). Conclusions Obesity is more likely to reduce mortality risk than normal weight, especially in elderly patients.",
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Body mass index and clinical outcomes in patients after ischaemic stroke in South Korea : A retrospective cohort study. / Choi, Heekyoung; Nam, Hyo Suk; Han, Euna.

In: BMJ open, Vol. 9, No. 8, e028880, 01.08.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Body mass index and clinical outcomes in patients after ischaemic stroke in South Korea

T2 - A retrospective cohort study

AU - Choi, Heekyoung

AU - Nam, Hyo Suk

AU - Han, Euna

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Objectives Although obesity is a risk factor for stroke, its impact on mortality in patients with stroke remains unclear. In this study, we aimed to evaluate the relationship between body mass index (BMI) and mortality due to ischaemic stroke among adults aged 20 years and above in Korea. Design Retrospective cohort study. Setting A tertiary-hospital-based stroke registry linked to the death records. Participants 3599 patients admitted for ischaemic stroke from January 2007 to June 2013. Outcome measures The HRs for all-cause and stroke-related mortality were calculated using Cox proportional hazards models. Progression from stroke-related mortality was assessed using the Fine-Grey competing risk model, treating other-cause mortality as a competing risk. Adjustments were made for age, gender, smoking status, Charlson comorbidity index, cardiovascular or non-cardiovascular comorbidities, stroke severity, severity related to other medical conditions, complications and enrolment year. We repeated the analysis with stratification based on age groups (less than 65 vs 65 years and above). Results For stroke-related mortality, there was no significant difference among the four BMI groups. The risk of all-cause mortality was 36% higher in the underweight group than in the normal weight group (long-term HR=1.36, 95% CI: 1.04 to 1.79), whereas the mortality risk of the obese group was significantly lower (HR=0.66, 95% CI: 0.54 to 0.81). Although this relationship was not estimated in the younger group, it was found that obesity had a protective effect on the all-cause mortality in the elderly (long-term HR=0.66, 95% CI: 0.52 to 0.83). Conclusions Obesity is more likely to reduce mortality risk than normal weight, especially in elderly patients.

AB - Objectives Although obesity is a risk factor for stroke, its impact on mortality in patients with stroke remains unclear. In this study, we aimed to evaluate the relationship between body mass index (BMI) and mortality due to ischaemic stroke among adults aged 20 years and above in Korea. Design Retrospective cohort study. Setting A tertiary-hospital-based stroke registry linked to the death records. Participants 3599 patients admitted for ischaemic stroke from January 2007 to June 2013. Outcome measures The HRs for all-cause and stroke-related mortality were calculated using Cox proportional hazards models. Progression from stroke-related mortality was assessed using the Fine-Grey competing risk model, treating other-cause mortality as a competing risk. Adjustments were made for age, gender, smoking status, Charlson comorbidity index, cardiovascular or non-cardiovascular comorbidities, stroke severity, severity related to other medical conditions, complications and enrolment year. We repeated the analysis with stratification based on age groups (less than 65 vs 65 years and above). Results For stroke-related mortality, there was no significant difference among the four BMI groups. The risk of all-cause mortality was 36% higher in the underweight group than in the normal weight group (long-term HR=1.36, 95% CI: 1.04 to 1.79), whereas the mortality risk of the obese group was significantly lower (HR=0.66, 95% CI: 0.54 to 0.81). Although this relationship was not estimated in the younger group, it was found that obesity had a protective effect on the all-cause mortality in the elderly (long-term HR=0.66, 95% CI: 0.52 to 0.83). Conclusions Obesity is more likely to reduce mortality risk than normal weight, especially in elderly patients.

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U2 - 10.1136/bmjopen-2018-028880

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