Key result
Overweight (OR 0.57; 95% CI 0.35-0.92) and obese (OR 0.67; 95% CI 0.51-0.89) individuals had lower risks of 1-year mortality after cardiac arrest compared to those with normal BMI.
Why the study?
The influence of an individual's body mass index on cardiac arrest outcomes remains uncertain.
Does body mass index category impact mortality and neurological outcomes in patients experiencing cardiac arrest?
Meta-Analysis
Does body mass index category impact mortality and neurological outcomes in patients experiencing cardiac arrest?
Overweight and obese patients may have a lower risk of long-term mortality following in-hospital cardiac arrest compared to those with normal BMI, suggesting an obesity paradox in this population.
Answers are grounded in this paper and cite their sources.
BMI categorization does not guide post-arrest prognosis; leaves open whether weight-specific interventions affect survival.
The influence of an individual's body mass index (BMI) on cardiac arrest outcomes remains uncertain. The aim of this study is to evaluate the impact of BMI categories (underweight, normal BMI, overweight, and obese) on mortality and neurological outcomes in patients experiencing cardiac arrest. We comprehensively searched standard electronic databases (PubMed, EMBASE, and Scopus) for relevant observational studies published in peer-reviewed journals written in English. We calculated pooled effect estimates using random-effects models and reported them as odds ratios (ORs) with 95% confidence intervals (CIs). We included 20 studies in our meta-analysis. Individuals with normal BMIs and those who were underweight had similar risks of in-hospital mortality (OR, 1.20; 95% CI, 0.90-1.60), mortality within 6 months of discharge (OR, 0.92; 95% CI, 0.59-1.42), mortality after the 1-year follow-up (OR, 2.42; 95% CI, 0.96-6.08), and odds of favorable neurological outcomes at hospital discharge (OR, 0.86; 95% CI, 0.53-1.39) and at the 6-month follow-up (OR, 0.73; 95% CI, 0.47-1.13). The risks of in-hospital mortality and mortality within 6 months of discharge in overweight and obese individuals were similar to those in individuals with normal BMIs. However, overweight (OR, 0.57; 95% CI, 0.35-0.92) and obese individuals (OR, 0.67; 95% CI, 0.51-0.89) had lower risks of mortality after their 1-year follow-ups. For overweight and obese subjects, the reduced risk of mortality after the 1 year of follow-up was noted only for those with in-hospital cardiac arrest and not for those with out-of-hospital cardiac arrest. The odds of favorable neurological outcomes in both overweight and obese individuals were similar to those with normal BMIs. BMI does not significantly impact short-term mortality or neurological outcomes. Overweight and obese individuals appear to have a lower risk of long-term mortality, but this differed by the place of arrest and needs to be confirmed by others.
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Xie et al. (2023) conducted a meta-analysis in Cardiac arrest. Overweight and obesity vs. Normal BMI was evaluated on Mortality after the 1-year follow-up (overweight vs normal BMI) (OR 0.57, 95% CI 0.35-0.92). Overweight (OR 0.57; 95% CI 0.35-0.92) and obese (OR 0.67; 95% CI 0.51-0.89) individuals had lower risks of 1-year mortality after cardiac arrest compared to those with normal BMI.
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