ArticleJournal of clinical medicine2022
The Obesity Paradox in Real-World Nation-Wide Cohort of Patients Admitted for a Stroke in the U.S.
Article in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Healthcare Resource Utilisation and Cost of Obesity and Related Complications in the United States: A Systematic Literature Review.Diabetes, obesity & metabolism · 2026Pooled it
- In-hospital Mortality Associated with Granulomatosis with Polyangiitis and Microscopic Polyangiitis Complicated with Respiratory Failure.Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG · 2026Article
- Obesity paradox in patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary intervention: A nationwide retrospective observational study.American heart journal plus : cardiology research and practice · 2026Article
- Revisiting the Obesity Paradox: Stroke Subtype-Specific Associations of BMI and WHR with Functional Outcome.Cerebrovascular diseases extra · 2026Article
- The outcomes of the obesity paradox in pulmonary embolism: a study of the national inpatient sample database from 2016 to 2020.Annals of hematology · 2025Article
- Evaluating machine learning models for stroke prediction based on clinical variables.Frontiers in neurology · 2025Article
- Article
- Nationwide Trends in Hospitalizations for Atrial Fibrillation and Flutter in the United States before and during the Outbreak of the COVID-19 Pandemic.Journal of clinical medicine · 2024Article
- The obesity paradox and 90 day mortality in chronic critically ill patients: a cohort study using a large clinical database.European journal of medical research · 2024Article
- Synergistic Effect of β-Cryptoxanthin and Epigallocatechin Gallate on Obesity Reduction.Nutrients · 2024Article
- Prediction of early neurological deterioration in acute ischemic stroke patients treated with intravenous thrombolysis.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2023Article
- Obesity paradox and stroke outcomes according to stroke subtype: a propensity score-matched analysis.International journal of obesity (2005) · 2023Review
- Combined Ingestion of Tea Catechin and Citrus β-Cryptoxanthin Improves Liver Function via Adipokines in Chronic Obesity.Nutrients · 2023Article
- The Relationship between Body Mass Index and In-Hospital Mortality in Bacteremic Sepsis.Journal of clinical medicine · 2023Article
- Association of body mass index and waist-to-height ratio with outcomes in ischemic stroke: results from the Third China National Stroke Registry.BMC neurology · 2023Article
- Anti-Obesity and Anti-Inflammatory Synergistic Effects of Green Tea Catechins and Citrus β-Cryptoxanthin Ingestion in Obese Mice.International journal of molecular sciences · 2023Article
- Being Underweight Is Associated with Increased Risk of Sudden Cardiac Death in People with Diabetes Mellitus.Journal of clinical medicine · 2023Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Obesity has been associated with increased incidence and severity of various cardiovascular risk factors and increased risk for stroke. However, the evidence of its effect on outcomes in stroke victims have been equivocal. We aimed to investigate the distribution of BMI in a nation-wide cohort of individuals, admitted for a stroke, and the relationship between BMI and in-hospital mortality. Methods: Data from the U.S. National Inpatient Sample (NIS) was collected, to identify hospitalizations for stroke, between October 2015 and December 2016. The patients were sub-divided into six groups based on their BMI: underweight, normal weight, overweight, obese I, obese II and extremely obese groups. Various sociodemographic and clinical parameters were gathered, and incidence of mortality and the length of hospital stay were analyzed. Multivariable analysis was performed to identify independent predictors of in-hospital mortality. Results: A weighted total of 84,185 hospitalizations for stroke were included in the analysis. The approximate mean patients aged was 65.5 ± 31 years, the majority being female (55.3%) and white (63.1%). The overall in-hospital mortality during the study period was 3.6%. A reverse J-shaped relationship between the body mass index and in-hospital mortality was documented, while patients with elevated BMI showed significantly lower in-hospital mortality compared to the underweight and normal weight study participants, 2.8% vs. 7.4%, respectively, p < 0.001. Age and several comorbidities, as well as the Deyo Comorbidity Index, were found to predict mortality in a multivariable analysis. Conclusion: A reverse J-shaped relationship between body mass index and in-hospital mortality was documented in patients admitted for a stroke in the U.S. during the study period. The above findings support the existence of an “obesity paradox” in patients hospitalized following a stroke, similar to that described in other cardiovascular conditions.
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