Effect of body mass index on inpatient rehabilitation outcome after stroke in a Southeast Asian cohort: a prospective study.

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Singapore medical journal Pub Date : 2024-04-01 Epub Date: 2021-10-31 DOI:10.11622/smedj.2021190

Sze Chin Jong, Jovic Aguipo Fuentes, Angie En Qin Seow, Chien Joo Lim, Gobinathan Chandran, Karen Sui Geok Chua

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引用次数: 0

Abstract

Introduction: We examined the association between admission body mass index (BMI) and discharge rehabilitation functional outcome using the functional independence measure (FIM) in a Southeast Asian cohort of stroke patients during inpatient rehabilitation.

Methods: A prospective, observational cohort study of stroke patients admitted to a single inpatient rehabilitation unit was conducted. Using the World Health Organization Asian standards, BMI was classified as underweight (<18.5 kg/m 2 ), normal (18.5-22.9 kg/m 2 ) and overweight (≥23 kg/m 2 ). The primary outcome measure was discharge FIM, and secondary outcomes included FIM gain, FIM efficiency and FIM effectiveness.

Results: Two hundred and forty-seven stroke subjects were enrolled. The mean age of the cohort was 59.48 (standard deviation [SD] 12.35) years; 64.4% ( n = 159) were male and 52.6% ( n = 130) had ischaemic stroke. The distributions of underweight, normal and overweight based on BMI on admission were 10.9% ( n = 27), 33.2% ( n = 82) and 55.9% ( n = 138), respectively, and the distributions upon discharge were 11.7% ( n = 29), 38.1% ( n = 94) and 50.2% (n = 124), respectively. Significant small decreases in BMI from admission to discharge were found (median [interquartile range] 23.58 [23.40-24.70] vs. 23.12 [22.99-24.21]; P < 0.001). Similarly, clinically significant FIM gains (mean ΔFIM 26.71; 95% confidence interval 24.73, 28.69, P < 0.001) were noted after a median length of stay of 36 days. No significant relationships were found between BMI and discharge FIM ( P = 0.600), FIM gain ( P = 0.254), FIM efficiency ( P = 0.412) or FIM effectiveness ( P = 0.796).

Conclusion: Findings from this study unequivocally support the benefits of acute inpatient stroke rehabilitation. Patients in the obese BMI range tended to normalise during rehabilitation. Body mass index, whether underweight, normal or overweight, did not correlate with discharge FIM.

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体质指数对东亚队列中风后住院康复结果的影响：一项前瞻性研究。

简介：我们使用功能独立性测量法（FIM）研究了东亚一组住院康复的脑卒中患者入院时体重指数（BMI）与出院时康复功能结果之间的关系：方法：对在一家住院康复中心住院的脑卒中患者进行了一项前瞻性队列观察研究。根据世界卫生组织的亚洲标准，BMI 被分为体重不足（< 18.5 kg/m2）、正常（18.5-22.9 kg/m2）和超重（≥ 23 kg/m2）。结果：247 名脑卒中受试者（平均年龄 59.48 [SD 12.35] 岁，64.4% [159] 为男性，52.6% [130] 为缺血性脑卒中）参加了此次研究。入院时体重指数过轻、正常和过重的分布分别为 10.9% (27)、33.2% (82) 和 55.9% (138)，出院时分别为 11.7% (29)、38.1% (94) 和 50.2% (124)。从入院（中位数[IQR]：23.58 [23.40，24.70]）到出院（中位数[IQR]：23.12 [22.99，24.21]），BMI 均有显著的小幅下降（p < 0.001）。同样，在住院时间中位数为 36 天后，FIM 有了明显的临床改善（平均 FIM 26.71 [95% CI: 24.73, 28.69]，p < 0.001）。BMI与出院FIM（P = 0.600）、FIM增益（P = 0.254）、FIM效率（P = 0.412）和FIM效果（P = 0.796）之间均无明显关系：本研究结果明确支持急性卒中住院康复治疗的益处。肥胖 BMI 范围内的患者在康复过程中趋于正常。体重指数（无论是体重不足、正常还是超重）与出院时的 FIM 无关。

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

Singapore medical journal MEDICINE, GENERAL & INTERNAL-

CiteScore

3.40

自引率

3.70%

发文量

149

审稿时长

3-6 weeks

期刊介绍： The Singapore Medical Journal (SMJ) is the monthly publication of Singapore Medical Association (SMA). The Journal aims to advance medical practice and clinical research by publishing high-quality articles that add to the clinical knowledge of physicians in Singapore and worldwide. SMJ is a general medical journal that focuses on all aspects of human health. The Journal publishes commissioned reviews, commentaries and editorials, original research, a small number of outstanding case reports, continuing medical education articles (ECG Series, Clinics in Diagnostic Imaging, Pictorial Essays, Practice Integration & Life-long Learning [PILL] Series), and short communications in the form of letters to the editor.