{"title":"体重指数对急性脑血管闭塞患者功能结局的影响。","authors":"Yu Kinoshita, Fumihiro Sakakibara, Shinichi Yoshimura, Kazutaka Uchida, Nobuyuki Sakai, Hiroshi Yamagami, Takeshi Morimoto","doi":"10.1159/000546728","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and purpose: </strong>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.</p><p><strong>Methods: </strong>We performed a post-hoc analysis of the RESCUE-Japan Registry 2 including 2,420 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 Low-BMI and High-BMI groups relative to 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 to 2 at 90 days, symptomatic intracranial hemorrhage (ICH), and any ICH within 72 hours from the onset.</p><p><strong>Results: </strong>Among total 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 Low-BMI group were older, more female, poorer premorbid status, severer symptom presentation, and more dominant of occlusion of the internal carotid artery or M1 segment of the middle cerebral artery. The Low-BMI group less used rt-PA and EVT. The primary outcome occurred 46.4%, 31.2%, and 23.7% in Low-BMI, Normal-BMI, and High-BMI groups, respectively. The adjusted odds ratios (ORs) (95% confidence intervals [CIs]) of the primary outcome of Low-BMI and High-BMI groups relative to Normal-BMI group were 1.59 (1.18-2.13) and 0.80 (0.60-1.07), respectively. The mRS score of 0 to 2 in 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 to 2 of Low-BMI and High-BMI groups relative to 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 Low-BMI and High-BMI groups relative to Normal-BMI group were 1.57 (0.84-2.95) and 1.31 (0.75-2.29), respectively.</p><p><strong>Conclusions: </strong>The low BMI was associated with a severity and poorer functional outcomes in patients with acute cerebral LVO.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-18"},"PeriodicalIF":2.2000,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of body mass index on functional outcomes in patients with acute cerebral large vessel occlusion.\",\"authors\":\"Yu Kinoshita, Fumihiro Sakakibara, Shinichi Yoshimura, Kazutaka Uchida, Nobuyuki Sakai, Hiroshi Yamagami, Takeshi Morimoto\",\"doi\":\"10.1159/000546728\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and purpose: </strong>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.</p><p><strong>Methods: </strong>We performed a post-hoc analysis of the RESCUE-Japan Registry 2 including 2,420 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 Low-BMI and High-BMI groups relative to 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 to 2 at 90 days, symptomatic intracranial hemorrhage (ICH), and any ICH within 72 hours from the onset.</p><p><strong>Results: </strong>Among total 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 Low-BMI group were older, more female, poorer premorbid status, severer symptom presentation, and more dominant of occlusion of the internal carotid artery or M1 segment of the middle cerebral artery. The Low-BMI group less used rt-PA and EVT. The primary outcome occurred 46.4%, 31.2%, and 23.7% in Low-BMI, Normal-BMI, and High-BMI groups, respectively. The adjusted odds ratios (ORs) (95% confidence intervals [CIs]) of the primary outcome of Low-BMI and High-BMI groups relative to Normal-BMI group were 1.59 (1.18-2.13) and 0.80 (0.60-1.07), respectively. The mRS score of 0 to 2 in 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 to 2 of Low-BMI and High-BMI groups relative to 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 Low-BMI and High-BMI groups relative to Normal-BMI group were 1.57 (0.84-2.95) and 1.31 (0.75-2.29), respectively.</p><p><strong>Conclusions: </strong>The low BMI was associated with a severity and poorer functional outcomes in patients with acute cerebral LVO.</p>\",\"PeriodicalId\":9683,\"journal\":{\"name\":\"Cerebrovascular Diseases\",\"volume\":\" \",\"pages\":\"1-18\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-06-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cerebrovascular Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000546728\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cerebrovascular Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000546728","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Effects of body mass index on functional outcomes in patients with acute cerebral large vessel occlusion.
Background and purpose: 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 2,420 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 Low-BMI and High-BMI groups relative to 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 to 2 at 90 days, symptomatic intracranial hemorrhage (ICH), and any ICH within 72 hours from the onset.
Results: Among total 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 Low-BMI group were older, more female, poorer premorbid status, severer symptom presentation, and more dominant of occlusion of the internal carotid artery or M1 segment of the middle cerebral artery. The Low-BMI group less used rt-PA and EVT. The primary outcome occurred 46.4%, 31.2%, and 23.7% in Low-BMI, Normal-BMI, and High-BMI groups, respectively. The adjusted odds ratios (ORs) (95% confidence intervals [CIs]) of the primary outcome of Low-BMI and High-BMI groups relative to Normal-BMI group were 1.59 (1.18-2.13) and 0.80 (0.60-1.07), respectively. The mRS score of 0 to 2 in 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 to 2 of Low-BMI and High-BMI groups relative to 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 Low-BMI and High-BMI groups relative to Normal-BMI group were 1.57 (0.84-2.95) and 1.31 (0.75-2.29), respectively.
Conclusions: The low BMI was associated with a severity and poorer functional outcomes in patients with acute cerebral LVO.
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.
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