Key result
Morbid obesity is linked to ~13% lower in-hospital mortality in patients hospitalized with heart failure.
Why the study?
Although studies show a positive link between cardiovascular mortality and BMI, several have observed lower mortality among obese heart failure patients, prompting assessment of BMI's impact on in-hospital outcomes.
Does obesity reduce in-hospital mortality in patients hospitalized with heart failure?
Cohort (n=8,674,190)
Yes
Does obesity reduce in-hospital mortality in patients hospitalized with heart failure?
Odds Ratio: 0.87 (95% CI 0.81–0.92)
Absolute Event Rate: 3.1% vs 5.6%
p-value: p=<0.001
This large nationwide analysis confirms the existence of the 'obesity paradox' in heart failure, showing lower in-hospital mortality in obese and morbidly obese patients compared to non-obese patients.
BACKGROUND: Heart failure (HF) remains one of the leading causes of death in the United States. While many large-scale studies show a positive relationship between cardiovascular mortality and body mass index (BMI), several studies have also observed lower mortality rates among obese HF patients. Therefore, we sought to assess the impact of BMI on in-hospital outcomes in patients admitted with HF. METHODS: Patients hospitalized with congestive heart failure (CHF) diagnosis between 2005 and 2014 were identified from the US National Inpatient Sample database using the International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic and procedural codes. The sample was divided into three groups based on their BMI. In-hospital outcomes were assessed in different groups and sub-groups. RESULTS: than those with BMI <30 (OR 0.87; CI 0.81-0.92). CONCLUSION: Even though this study supports the findings of previous smaller studies illustrating the existence of the "obesity paradox" in HF hospitalizations, the pathogenesis behind this paradoxical effect is still unclear.
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Brgdar et al. (2022) conducted a cohort in Heart failure (n=8,674,190). Obesity (BMI ≥30 kg/m2) vs. BMI <30 kg/m2 was evaluated on In-hospital mortality (OR 0.87, 95% CI 0.81-0.92, p=<0.001). Morbidly obese patients (BMI ≥40) hospitalized with heart failure had significantly lower in-hospital mortality compared to those with BMI <30 (OR 0.87, 95% CI 0.81-0.92).
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