Effects of Body Mass Index on Functional Outcomes in Patients with Acute Cerebral Large Vessel Occlusion.

IF 1.5 3区医学 Q3 CLINICAL NEUROLOGY

Cerebrovascular Diseases Pub Date : 2025-06-21 DOI:10.1159/000546728

Yu Kinoshita, Fumihiro Sakakibara, Shinichi Yoshimura, Kazutaka Uchida, Nobuyuki Sakai, Hiroshi Yamagami, Takeshi Morimoto

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Abstract

Introduction: The effect of body mass index (BMI) on the outcome of acute cerebral large vessel occlusion (LVO) was uncertain in the era of endovascular therapy (EVT). We investigated the association between BMI and functional outcomes in patients with acute cerebral LVO.

Methods: We performed a post hoc analysis of the RESCUE-Japan Registry 2 including 2,408 LVO patients among 46 stroke centers in Japan. The patients were categorized into 3 groups depending on their BMI (kg/m2): Low-BMI group: BMI <18.5, Normal-BMI group: 18.5≤ BMI <25, and High-BMI group: BMI ≥25. We estimated the effect of the Low-BMI and High-BMI groups relative to the Normal-BMI group. The primary outcome was a modified Rankin Scale (mRS) score of 5 or 6 at 90 days from the onset. The secondary outcomes consisted of an mRS score of 0-2 at 90 days, symptomatic intracranial hemorrhage (ICH), and any ICH within 72 h from the onset.

Results: Among a total of 2,234 analyzed patients, Low-BMI, Normal-BMI, and High-BMI groups accounted for 14.5%, 63.7%, and 21.9%, respectively. The patients in the Low-BMI group were older, more female, poorer premorbid status, severe symptom presentation, and more dominant of occlusion of the internal carotid artery or M1 segment of the middle cerebral artery. The Low-BMI group used less recombinant tissue plasminogen activator and EVT. The primary outcome occurred 46.4%, 31.2%, and 23.7% in the Low-BMI, Normal-BMI, and High-BMI groups, respectively. The adjusted odds ratios (ORs) (95% confidence intervals [CIs]) of the primary outcome of the Low-BMI and High-BMI groups relative to the Normal-BMI group were 1.59 (1.18-2.13) and 0.80 (0.60-1.07), respectively. The mRS score of 0-2 in the Low-BMI, Normal-BMI, and High-BMI groups consisted of 26.3%, 38.8%, and 41.9%, respectively. The adjusted OR (95% CIs) of an mRS score of 0-2 for the Low-BMI and High-BMI groups relative to the Normal-BMI group were 0.72 (0.53-0.99) and 0.83 (0.64-1.06), respectively. The adjusted OR (95% CIs) of symptomatic ICH of the Low-BMI and High-BMI groups relative to the Normal-BMI group were 1.57 (0.84-2.95) and 1.31 (0.75-2.29), respectively.

Conclusion: The low BMI was associated with a severity and poorer functional outcomes in patients with acute cerebral LVO.

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体重指数对急性脑血管闭塞患者功能结局的影响。

背景与目的：在血管内治疗（EVT）时代，身体质量指数（BMI）对急性脑血管闭塞（LVO）预后的影响尚不明确。我们研究了急性脑LVO患者的BMI和功能结局之间的关系。方法：我们对RESCUE-Japan Registry 2进行了事后分析，包括日本46个卒中中心的2420例LVO患者。根据BMI （kg/m2）将患者分为3组；低BMI组：BMI < 18.5，正常BMI组：18.5≤BMI < 25，高BMI组：BMI≥25。我们估计了低bmi和高bmi组相对于正常bmi组的影响。主要结果是发病后90天的改良Rankin量表（mRS）评分为5或6分。次要结果包括90天mRS评分0到2分，症状性颅内出血（ICH），以及发病后72小时内的任何ICH。结果：在分析的2234例患者中，低bmi、正常bmi和高bmi组分别占14.5%、63.7%和21.9%。低bmi组患者年龄大，女性多，病前状态差，症状表现严重，以颈内动脉或大脑中动脉M1段闭塞为主。低bmi组较少使用rt-PA和EVT。低bmi、正常bmi和高bmi组的主要结局发生率分别为46.4%、31.2%和23.7%。低bmi组和高bmi组的主要结局相对于正常bmi组的调整优势比（or）（95%可信区间[ci]）分别为1.59（1.18-2.13）和0.80（0.60-1.07）。低bmi组、正常bmi组和高bmi组mRS评分为0 ~ 2分的分别占26.3%、38.8%和41.9%。低bmi组和高bmi组相对于正常bmi组mRS评分为0 ~ 2的校正OR （95% ci）分别为0.72（0.53 ~ 0.99）和0.83（0.64 ~ 1.06）。低bmi组和高bmi组症状性脑出血与正常bmi组的校正OR （95% ci）分别为1.57（0.84-2.95）和1.31（0.75-2.29）。结论：低BMI与急性脑LVO患者的严重程度和较差的功能预后相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cerebrovascular Diseases 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

审稿时长

1 months

期刊介绍： A rapidly-growing field, stroke and cerebrovascular research is unique in that it involves a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. ''Cerebrovascular Diseases'' is an international forum which meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues, dealing with all aspects of stroke and cerebrovascular diseases. It contains original contributions, reviews of selected topics and clinical investigative studies, recent meeting reports and work-in-progress as well as discussions on controversial issues. All aspects related to clinical advances are considered, while purely experimental work appears if directly relevant to clinical issues.