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

Heekyung Lee, Hyungoo Shin, Jaehoon Oh, Tae-Ho Lim, Bo-Seung Kang, Hyunggoo Kang, Hyuk-Joong Choi, Changsun Kim and Jung-Hwan Park
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Heekyung Lee: Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea
Hyungoo Shin: Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea
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

IJERPH, 2021, vol. 18, issue 16, 1-13

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.

Keywords: body mass index; obesity; heart arrest; cardiopulmonary resuscitation; patient outcome assessment; meta-analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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