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Correlation between severity of obesity and mortality in cardiogenic shock

Published:September 06, 2022DOI:https://doi.org/10.1016/j.hrtlng.2022.08.022

      Highlights

      • The mean BMI (Body Mass Index) for our cohort was 31.1 kg/m2 (SD 8 kg/m2).
      • BMI for patients that survived compared to those that did not was 29.7 kg/m2 vs. 33.7 kg/m2 (p = 0.04).
      • Incremental increase in obesity classification was associated with a 1.6 (95% CI 1.1 – 2.6, p = 0.03) odds of mortality.

      Abstract (222/250)

      Introduction

      Cardiogenic shock (CS) is associated with high mortality despite the development of risk stratification tools and new treatment strategies. Obesity, although a risk factor for cardiovascular disease, is not included in current risk stratification tools for CS. A relationship between mortality and obesity has only been shown in subsets populations of CS; there is not yet a clear relationship between severity of obesity and all-cause CS.

      Objectives

      In this study we evaluate the relationship between rising body mass index (BMI) and mortality in all-cause CS. Methods: All patients with BMI measurements and hospitalizations complicated by CS from 2014 to 2019 at a single quaternary care institution were identified. Patients were grouped by obesity classification. Multivariate logistic regression was performed to determine a relationship between higher obesity classifications with 30-day mortality in patients with CS.

      Results

      Seventy-two patients were available for analysis. Mean BMI for those who survived compared to those who did not was 29.7 ± 8 kg/m2 vs 33.7 ± 7.6 kg/m2 (p = 0.04). The odds ratio for mortality with incremental increase in obesity classification was 1.6 (95% CI 1.1 – 2.6, p = 0.03) after adjusting for etiology of CS and other common associations with CS mortality.

      Conclusion

      This study suggests that the higher mortality risk with incremental increases in BMI should be taken into account when risk stratifying these patients.

      Keywords

      Abbreviation:

      CS (cardiogenic shock), BMI (body mass index), UW (underweight), NW (normal weight), OW (overweight), OB (obese), C1O (Class I Obesity), C2O (Class II Obesity), C3O (Class III Obesity), CPI (cardiac power index), PAPi (pulmonary artery pulsatility index)
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