Key result
In patients with acute ischemic stroke, being overweight was associated with a decreased risk of a poor functional outcome at 3 months (OR 0.83) compared to normal weight, while underweight increased the risk.
Why the study?
It was unclear whether body weight is associated with functional outcome after acute ischemic stroke.
Does body mass index affect the risk of poor functional outcome in patients with acute ischemic stroke?
Cohort (n=11,749)
Yes
Does body mass index affect the risk of poor functional outcome in patients with acute ischemic stroke?
Body weight has a non-linear relationship with functional outcomes after acute ischemic stroke, where being underweight increases the risk of poor outcomes and being overweight decreases it, while obesity shows no significant difference compared to normal weight.
Answers are grounded in this paper and cite their sources.
Should not alter weight management in acute ischemic stroke; hypothesis-generating for the obesity paradox and requires prospective validation.
This study aimed to determine whether body weight is associated with functional outcome after acute ischemic stroke. We measured the body mass index (BMI) and assessed clinical outcomes in patients with acute ischemic stroke. The BMI was categorized into underweight (< 18.5 kg/m 2 ), normal weight (18.5–22.9 kg/m 2 ), overweight (23.0–24.9 kg/m 2 ), and obesity (≥ 25.0 kg/m 2 ). The association between BMI and a poor functional outcome (modified Rankin Scale [mRS] score: 3–6) was evaluated. We included 11,749 patients with acute ischemic stroke (70.3 ± 12.2 years, 36.1% women). The risk of a 3-month poor functional outcome was higher for underweight, lower for overweight, and did not change for obesity in reference to a normal weight even after adjusting for covariates by logistic regression analysis. Restricted cubic splines and SHapley Additive exPlanation values in eXtreme Gradient Boosting model also showed non-linear relationships. Associations between BMI and a poor functional outcome were maintained even after excluding death (mRS score: 3–5) or including mild disability (mRS score: 2–6) as the outcome. The associations were strong in older patients, non-diabetic patients, and patients with mild stroke. Body weight has a non-linear relationship with the risk of a poor functional outcome after acute ischemic stroke.
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Wakisaka et al. (2023) conducted a cohort in Acute ischemic stroke (n=11,749). Overweight (BMI 23.0-24.9 kg/m2) vs. Normal weight (BMI 18.5-22.9 kg/m2) was evaluated on Poor functional outcome (modified Rankin Scale score 3-6) at 3 months (OR 0.83, 95% CI 0.71-0.96, p=0.02). In patients with acute ischemic stroke, being overweight was associated with a decreased risk of a poor functional outcome at 3 months (OR 0.83) compared to normal weight, while underweight increased the risk.
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