Impact of the obesity paradox on 28-day mortality in elderly patients critically ill with cardiogenic shock: a retrospective cohort study
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Summary
This summary is machine-generated.In elderly patients with cardiogenic shock (CS), being underweight is a risk factor for 28-day mortality. However, overweight and obesity do not significantly impact the prognosis for these critically ill patients.
Area Of Science
- Cardiology
- Critical Care Medicine
- Geriatrics
Background
- The obesity paradox, where higher body weight is associated with better survival in cardiovascular disease (CVD), is debated in elderly patients with cardiogenic shock (CS).
- Previous research indicates an obesity paradox in CVD, but its applicability to elderly CS patients remains unclear.
Purpose Of The Study
- To investigate the impact of obesity, defined by body mass index (BMI), on the 28-day prognosis of elderly patients experiencing cardiogenic shock.
- To determine if overweight or obesity influences survival rates in critically ill elderly individuals with CS.
Main Methods
- Utilized data from the Medical Information Market in Critical Care IV (MIMIC-IV) database.
- Categorized critically ill CS patients into young adult (<65 years) and elderly (≥65 years) groups.
- Subdivided patients based on BMI (≥30 kg/m² vs. <30 kg/m²) to assess 28-day prognosis, mechanical ventilation, and length of stay.
Main Results
- Analysis of 1827 CS patients revealed underweight (BMI < 18.5) as a significant risk factor for 28-day mortality in the elderly (OR 2.42, P=0.039).
- Overweight (BMI 25-29.9) and obesity (BMI ≥30) were not associated with increased 28-day mortality risk in elderly CS patients.
- Kaplan-Meier curves indicated significantly higher 28-day survival in elderly CS patients with BMI ≥30 kg/m² compared to those with BMI <30 kg/m² (66.75% vs. 60.35%, P=0.024).
Conclusions
- Underweight status negatively impacts the 28-day prognosis for critically ill elderly patients with cardiogenic shock.
- Overweight and obesity do not appear to significantly affect the prognosis of elderly patients with cardiogenic shock.
- The findings suggest a potential protective effect of higher BMI in this specific patient population, warranting further investigation.
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