Effect of Body Mass Index on Short-Term Prognosis of Stroke Patients with Different Severity
Objective To investigate the effect of BMI on the 3-month clinical outcome of stroke patients with different severity.Methods This study was a prospective multicenter cohort study to observe the relationship between BMI and 3-month clinical outcome in patients hospitalized for the first stroke within 7 days of onset.According to the NIHSS score at admission,the patients were divided into the mild stroke(NIHSS score＜11 points)group and the moderate to severe stroke(NIHSS score≥ 11 points)group.The general data of the patients at admission and the risk factors of stroke such as hypertension and diabetes mellitus were collected.The BMI at admission,the presence of dysphagia,and pneumonia during hospitalization were recorded,and the BMI was divided into 4 levels according to quartiles.The patients were followed up 3 months after onset,and the mRS scores were collected.The mRS scores of 0-2 were considered to have a good prognosis,and 3-6 were considered to have a poor prognosis.The differences in BMI and other baseline indicators between the mild stroke group and the moderate to severe stroke group were compared.Multivariate analysis was used to explore the effect of different levels of BMI on the prognosis of stroke patients with different severity.Results A total of 733 patients were included,including 474(64.7％)males and 259(35.3％)females.There were 552(75.3％)patients with ischemic stroke and 181(24.7％).patients with hemorrhagic stroke.There were 526 patients in the mild stroke group and 207 patients in the moderate to severe stroke group.After adjusting for confounding factors,different levels of BMI had no significant effect on the 3-month outcome of the overall patients and mild stroke patients.Among patients with moderate to severe stroke,the proportion of patients with the highest quartile of BMI with a good prognosis at 3 months was lower than those with the lowest quartile of BMI(OR 0.376,95％CI0.142-0.992,P=0.048).Conclusions Different BMI levels have different effects on the short-term prognosis of patients with different severity of stroke.Among patients with moderate to severe stroke,a high BMI level may lead to poor prognosis.
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