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Association between Body Mass Index and Outcomes in Patients with Return of Spontaneous Circulation after Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis

Author

Listed:
  • Heekyung Lee

    (Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea
    These authors contributed equally to this work.)

  • Hyungoo Shin

    (Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea
    These authors contributed equally to this work.)

  • Jaehoon Oh

    (Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea)

  • Tae-Ho Lim

    (Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea)

  • Bo-Seung Kang

    (Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea)

  • Hyunggoo Kang

    (Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea)

  • Hyuk-Joong Choi

    (Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea)

  • Changsun Kim

    (Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea)

  • Jung-Hwan Park

    (Department of Internal Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea)

Abstract

Increased body mass index (BMI) is a risk factor for cardiovascular disease, stroke, and metabolic diseases. A high BMI may affect outcomes of post-cardiac arrest patients, but the association remains debatable. We aimed to determine the association between BMI and outcomes in patients with return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA). A systematic literature search was conducted using MEDLINE, EMBASE, and the Cochrane Library. Studies that included patients who presented ROSC after OHCA, had a recorded BMI, and were assessed for neurological outcomes and in-hospital mortality were included. To assess the risk of bias of each included study, we employed the Risk of Bias Assessment Tool for Non-randomized Studies. We assessed 2427 patients from six studies. Neurological outcomes were significantly poorer in underweight patients (risk ratio (RR) = 1.21; 95% confidence interval (CI) = 1.07–1.37; p = 0.002; I 2 = 51%) than in normal-weight patients. Additionally, in-hospital mortality rate was significantly higher in underweight patients (RR = 1.35; 95% CI = 1.14–1.60; p<0.001; I 2 = 21%) and in obese patients (RR = 1.25; 95% CI = 1.12–1.39; p<0.001; I 2 = 0%) than in normal-weight patients. Poor neurological outcome is associated with underweight, and low survival rate is associated with underweight and obesity in patients with ROSC after OHCA.

Suggested Citation

  • Heekyung Lee & Hyungoo Shin & Jaehoon Oh & Tae-Ho Lim & Bo-Seung Kang & Hyunggoo Kang & Hyuk-Joong Choi & Changsun Kim & Jung-Hwan Park, 2021. "Association between Body Mass Index and Outcomes in Patients with Return of Spontaneous Circulation after Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 18(16), pages 1-13, August.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:16:p:8389-:d:610643
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    References listed on IDEAS

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    1. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
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