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Correlation between severity of obesity and mortality in cardiogenic shock
Matthew S Delfiner1, Carlos Manuel Romero2, Catherine Dillane3
1Division of Cardiovascular Disease, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
Insights
Higher body mass index (BMI) is linked to increased mortality in cardiogenic shock (CS) patients. This finding suggests incorporating BMI into risk stratification for better patient outcomes in CS.
Area of Science:
- Cardiology
- Critical Care Medicine
- Obesity Research
Background:
- Cardiogenic shock (CS) has high mortality rates despite advancements in treatment and risk stratification.
- Obesity is a cardiovascular disease risk factor but is not currently integrated into CS risk assessment tools.
- Existing data on obesity and CS mortality is limited to specific patient subsets, lacking a clear link to obesity severity in all-cause CS.
Purpose of the Study:
- To investigate the association between increasing body mass index (BMI) and mortality in patients experiencing all-cause cardiogenic shock.
- To determine if obesity classification correlates with increased mortality risk in CS patients.
Main Methods:
- A retrospective analysis of 72 patients hospitalized with CS and available BMI measurements between 2014 and 2019.
- Patients were categorized based on obesity classifications.
- Multivariate logistic regression was employed to assess the relationship between obesity levels and 30-day mortality.
Main Results:
- Patients who did not survive CS had a higher mean BMI (33.7 ± 7.6 kg/m²) compared to survivors (29.7 ± 8 kg/m²), with statistical significance (p=0.04).
- An increased obesity classification was associated with a 1.6-fold higher odds of mortality (95% CI 1.1 - 2.6, p=0.03), even after adjusting for CS etiology and other mortality factors.
Conclusions:
- Elevated BMI is associated with increased mortality risk in patients with cardiogenic shock.
- The severity of obesity, indicated by BMI, should be considered in the risk stratification of CS patients for improved clinical management.
Introduction:
Cardiogenic shock (CS) is associated with high mortality despite the development of risk stratification tools and new treatment strategies. Obesity, although a risk factor for cardiovascular disease, is not included in current risk stratification tools for CS. A relationship between mortality and obesity has only been shown in subsets populations of CS; there is not yet a clear relationship between severity of obesity and all-cause CS.
Objectives:
In this study we evaluate the relationship between rising body mass index (BMI) and mortality in all-cause CS.
Methods:
All patients with BMI measurements and hospitalizations complicated by CS from 2014 to 2019 at a single quaternary care institution were identified. Patients were grouped by obesity classification. Multivariate logistic regression was performed to determine a relationship between higher obesity classifications with 30-day mortality in patients with CS.
Results:
Seventy-two patients were available for analysis. Mean BMI for those who survived compared to those who did not was 29.7 ± 8 kg/m2 vs 33.7 ± 7.6 kg/m2 (p = 0.04). The odds ratio for mortality with incremental increase in obesity classification was 1.6 (95% CI 1.1 - 2.6, p = 0.03) after adjusting for etiology of CS and other common associations with CS mortality.
Conclusion:
This study suggests that the higher mortality risk with incremental increases in BMI should be taken into account when risk stratifying these patients.
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