Association between obesity and neurological outcomes among out-of-hospital cardiac arrest patients: The SOS-KANTO 2017 study

Abstract

Aim: To assess the association between body mass index (BMI) and neurological outcomes among patients with out-of-hospital cardiac arrest (OHCA). Methods: This prospective, multicenter, observational study conducted between 2019 and 2021 included adults with OHCA who were hospitalized after return of spontaneous circulation. Based on the BMI, the patients were categorized as underweight (BMI < 18.5 kg/m2), normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25.0–29.9 kg/m2), or obese (BMI ≥ 30 kg/m2). The normal weight group served as the reference. Favorable neurological outcomes were defined as a Cerebral Performance Category score of ≤2 at 30 days. Multivariate logistic regression analyses were performed to adjust for patient characteristics, OHCA circumstances, and time variables. Results: Of the 9,909 patients with OHCA who presented during the study period, 637 were eligible, of whom 10.8% (69/637), 48.9% (312/637), 27.6% (176/637), and 12.5% (80/637) were underweight, normal weight, overweight, and obese, respectively. These groups had favorable neurological outcome in 23.2%, 29.2%, 20.5%, and 16.2% of patients, respectively. Obese and overweight patients had a significantly lower rate of favorable neurologic outcomes (adjusted odds ratio [OR] = 0.35; 95% confidence interval [CI] = 0.16–0.77; adjusted OR = 0.53; 95% CI = 0.31–0.90, respectively) than those with a normal weight. Conclusions: Obese and overweight patients with OHCA have reduced rates of favorable neurological outcomes, suggesting that clinicians should pay attention to the BMI of patients.

Keywords

• Obesity
• Body mass index
• Out-of-hospital cardiac arrest
• Outcome