Racial differences in intracerebral haemorrhage outcomes in patients with obesity Article

Full Text via DOI: 10.1002/osp4.167 PMID: 29951217 Web of Science: 000435802700007

Cited authors

  • Iwuchukwu, I.; Mahale, N.; Ryder, J.; Hsieh, B.; Jennings, B.; Nguyen, D.; Cornwell, K.; Beyl, R.; Zabaleta, J.; Sothern, M.

Abstract

  • ObjectiveThis study was conducted to determine the role of obesity and race in intracerebral haemorrhage (ICH) outcomes.; MethodsThe Get with the guideline-Stroke database was queried for all admitted patients with spontaneous ICH. Secondary causes of ICH were excluded. Body mass index (BMI) was classified using the Center for Disease Control guidelines. Race was classified as White or non-White. Demographics, clinical, imaging data were retrieved. Outcome measures were hematoma expansion at 24h and discharge disposition.; ResultsA total of 428 patients were included in our analysis. Female gender, past history of congestive heart failure, diabetes mellitus, HbA1c, blood pressure, ICH volume, ICH location, intraventricular haemorrhage and hospital length of stay deferred across BMI categories. On multivariate analysis, along with obese categories, age, ICH location and ICH volume were independent predictors of poor outcomes (hematoma expansion and poor discharge disposition). After adjusting for these variables, obesity remained a predictor of poor disposition outcome compared with normal and overweight subjects; Normal vs. Obese OR 0.26 CI 0.115-0.593 p=0.0014; Obese vs. Overweight OR 3.79 CI 1.68-8.52 p=0.0013. Nonetheless, obesity did not influence hematoma expansion. Overall, BMI-race classification did not influence outcomes. However, among non-Whites, the obese category had higher odds of a poor disposition outcome than normal (OR 6.84 CI 2.12-22.22 p=0.0013) or overweight (OR 8.45 CI 2.6-27.49 p=0.0004) categories.; ConclusionAn obesity paradox in ICH was not observed in our cohort. In the non-White population, patients with obesity were likely to be associated with poor disposition outcome. Similar findings were not observed in White population.

Publication date

  • 2018

Published in

Category

International Standard Serial Number (ISSN)

  • 2055-2238

Start page

  • 268

End page

  • 275

Volume

  • 4

Issue

  • 3