Association of Low Body Mass Index With In-Hospital Cardiac Arrest in Patients With Cerebro- and Cardiovascular...

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Body mass index (BMI) is a known marker for in-hospital cardiac arrest (IHCA) in patients with cerebro- and cardiovascular disease.
• The specific association between admission BMI and IHCA incidence remains controversial.
• This study investigates the relationship between BMI and IHCA in Japanese patients with cerebro- and cardiovascular disease.

Purpose of the Study:

• To examine the association between body mass index (BMI) on admission and the incidence of in-hospital cardiac arrest (IHCA).
• To identify potential risk factors for IHCA among patients with cerebro- and cardiovascular disease in Japan.

Main Methods:

• Retrospective analysis of the Japanese Registry Of All cardiac and vascular Diseases-Diagnosis Procedure Combination (JROAD-DPC) database (2012-2021).
• Inclusion of 7,571,826 patients hospitalized for cerebro- or cardiovascular disease from 10,923,676 total cases.
• BMI classification: underweight (<18.5 kg/m²), normal and under ideal (18.5-22 kg/m²), normal and over ideal (22-25 kg/m²), and obese (≥25.0 kg/m²).
• Cox regression analysis was performed to assess hazard risk for IHCA incidence.

Main Results:

• In-hospital cardiac arrest (IHCA) occurred in 3.57% of the studied patients (270,380 cases).
• The underweight BMI group (<18.5 kg/m²) demonstrated a significantly higher hazard risk for IHCA.
• This association remained significant after adjusting for confounding factors in both the overall patient cohort and age-specific subgroups.

Conclusions:

• Underweight status, rather than obesity, is identified as a potential risk factor for in-hospital cardiac arrest (IHCA).
• These findings have implications for managing cardiovascular disease patients, particularly in aging societies.
• Further research may be warranted to explore the mechanisms linking underweight status to increased IHCA risk.