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Association of Modified Body Mass Index With In-Hospital Outcomes After Intermediate or High-Risk Pulmonary Embolism
Danial Saleem1, Mahesh V Madhavan1,2, Caroline Der Nigoghossian1
1NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
Summary
Low modified body mass index (mBMI) is common in patients with intermediate or high-risk pulmonary embolism (PE). This frailty indicator independently predicts higher in-hospital mortality and bleeding risks following PE treatment.
Area of Science:
- Cardiology
- Critical Care Medicine
- Geriatrics
Background:
- Pulmonary embolism (PE) outcomes depend on severity and patient factors.
- Modified body mass index (mBMI) is a novel frailty surrogate with limited data on its association with PE outcomes.
- Understanding mBMI's role is crucial for risk stratification in PE patients.
Purpose of the Study:
- To investigate the association between mBMI and clinical outcomes in intermediate or high-risk PE patients.
- To determine if mBMI predicts mortality and bleeding after PE treatment.
- To evaluate mBMI as a prognostic marker in PE management.
Main Methods:
- Retrospective study of 843 patients with intermediate or high-risk PE (2013-2019).
- PE risk stratified using European Society of Cardiology guidelines.
- mBMI calculated as serum albumin concentration multiplied by body mass index; patients stratified by quartiles.
Main Results:
- Low mBMI was linked to more comorbidities and less interventional treatment.
- mBMI was independently associated with mortality (P=.005) and bleeding (P=.006) across quartiles.
- Highest mBMI quartile showed significantly lower mortality (OR, 0.28) and bleeding (OR, 0.42) risks compared to the lowest.
Conclusions:
- Low mBMI is prevalent in intermediate-risk and high-risk PE patients.
- mBMI is an independent predictor of in-hospital mortality and bleeding post-treatment.
- mBMI may serve as a valuable prognostic tool for PE patients.
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