Key result
Class III obesity was associated with higher in-hospital mortality compared to a nonobese phenotype in adults with cardiogenic shock requiring mechanical support (34.9% vs 26.4%; P<0.001).
Why the study?
The association of obesity on outcomes in patients with cardiogenic shock requiring acute mechanical circulatory support had not been thoroughly investigated.
Does obesity increase in-hospital mortality and 30-day readmission in adults with cardiogenic shock requiring acute mechanical circulatory support?
Cohort (n=35,555)
Yes
Does obesity increase in-hospital mortality and 30-day readmission in adults with cardiogenic shock requiring acute mechanical circulatory support?
Absolute Event Rate: 34.9% vs 26.4%
p-value: p=<0.001
Class II and III obesity are associated with significantly higher in-hospital mortality in patients with cardiogenic shock requiring acute mechanical circulatory support.
May warrant caution in obese cardiogenic shock; leaves open whether tailored strategies improve survival.
Background: The association of obesity on outcomes in patients with cardiogenic shock requiring acute mechanical circulatory support has not been thoroughly investigated. Methods: We evaluated the National Readmission Database for adults with either acute myocardial infarction or heart failure complicated by cardiogenic shock requiring acute mechanical circulatory support between January 2016 and November 2017. Exposure was assessed using International Classification of Diseases , Tenth Revision codes for the degree of obesity with the reference being body mass index (BMI) of 20.0 to 29.9 group. Multiple logistic regression and Cox regression analysis were used to analyze in-hospital mortality and 30-day readmission, respectively. Results: The survey-weighted sample included a total of 35 555 hospitalizations with a mean age of 65.4±0.2 years and 29.8% females. Obesity was associated with higher in-hospital mortality (no obesity, 26.4% [BMI, 20.0–29.9] versus class I obesity, 25.0% [BMI, 30.0–34.9] versus class II obesity, 28.7% [BMI, 35.0–39.9] versus class III obesity, 34.9% [BMI, ≥40]; P <0.001). On stratified analysis, compared with a nonobese phenotype, younger adults (age <60) with class II and class III obesity (odds ratio, 1.9 [95% CI, 1.1–3.5], P =0.02; odds ratio, 2.1 [95% CI, 1.2–3.7], P =0.01) and older adults (age ≥60) with class III obesity (odds ratio, 1.7 [95% CI, 1.2–2.4], P =0.005) had higher mortality. There was no association between the degree of obesity and 30-day readmission. Conclusions: Among adults with acute myocardial infarction or acute heart failure resulting in cardiogenic shock requiring acute mechanical circulatory support, younger adults with class II and class III obesity and older patients with class III obesity have a higher risk of in-hospital mortality compared with nonobese patients.
No takes yet. Share an insight, caveat, or question.
Sreenivasan et al. (2021) conducted a cohort in Acute myocardial infarction or heart failure complicated by cardiogenic shock requiring acute mechanical circulatory support (n=35,555). Obesity vs. Body mass index 20.0 to 29.9 (nonobese phenotype) was evaluated on In-hospital mortality (p=<0.001). Class III obesity was associated with higher in-hospital mortality compared to a nonobese phenotype in adults with cardiogenic shock requiring mechanical support (34.9% vs 26.4%; P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: