Background and Purpose-Limited data exist concerning obesity and
survival in patients after acute stroke. The objective of this study was
to investigate the association between obesity and survival in patients
with acute first-ever stroke.
Methods-Patients were prospectively investigated based on a standard
diagnostic protocol over a period of 16 years. Evaluation was performed
on admission, at 7 days, at 1, 3, and 6 months after discharge, and
yearly thereafter for up to 10 years after stroke. The study patients
were divided into 3 groups according to body mass index (BMI): normal
weight (<25 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (>= 30
kg/m(2)). Overall survival during follow-up was the primary end point.
The secondary end point was the overall composite cardiovascular events
over the study period.
Results-Based on our inclusion criteria, 2785 patients were recruited.
According to BMI, 1138 (40.9%) patients were of normal weight, 1113
(41.0%) were overweight, and 504 (18.1%) were obese. NIHSS score on
admission (mean, 11.28 +/- 8.65) was not different among the study
groups. Early (first week) survival in obese (96.4%; 95% CI,
94.8%-97.9%) and overweight patients (92.8%; 95% CI, 91.2%-94.4%)
was significantly higher compared to that of normal-weight patients
(90.2%; 95% CI, 88.4%-92.0%). Similarly, 10-year survival was 52.5%
(95% CI, 46.4%-58.6%) in obese, 47.4% (95% CI, 43.5%-51.3%) in
overweight, and 41.5% (95% CI, 39.7%-45.0%) in normal-weight
patients (log-rank test = 17.7; P < 0.0001). Overweight (HR, 0.82; 95%
CI, 0.71-0.94) and obese patients (HR, 0.71; 95% CI, 0.59-0.86) had a
significantly lower risk of 10-year mortality compared to normal-weight
patients after adjusting for all confounding variables.
Conclusions-Based on BMI estimation, obese and overweight stroke
patients have significantly better early and long-term survival rates
compared to those with normal BMI. (Stroke. 2011;42:30-36.