title: Influence of body mass index and age on functional outcomes in patients with subarachnoid hemorrhage.
abstract: BACKGROUND
  Recent studies have highlighted the obesity paradox where patients with obesity have a greater chance of survival than patients with normal weight.
  
  
  OBJECTIVE
  To investigate the association between body mass index (BMI) and age with severity of subarachnoid hemorrhage (SAH) and functional outcome.
  
  
  METHODS
  We retrospectively reviewed the charts of 274 consecutive patients admitted with SAH between June 2008 and June 2012. Data collected included patient demographic features (age, sex, BMI), severity of SAH at admission (Fisher grade, Hunt and Hess grade, Glasgow Coma Scale score, and the World Federation of Neurosurgeons Scale score), as well as functional outcome measured by the modified Rankin Scale (mRS) by death or discharge.
  
  
  RESULTS
  The median age was 57 years (range, 18-99), and 62% were female; the median BMI was 27 (range, 14.3-55.1). On multivariate analysis adjusting for age and sex, there was no evidence of an association between BMI and Hunt and Hess grade, Fisher grade, World Federation of Neurosurgeons Scale score, Glasgow Coma Scale score, or mRS score (all P≥.17). On multivariate analysis adjusting for BMI and sex, there was evidence of a higher mRS score (P<.001) and lower WFNS grade (P=.016) in older patients, with no significant association observed between age and the remaining 3 measures of SAH severity (all P≥.10).
  
  
  CONCLUSIONS
  The results of our study indicate that BMI is not noticeably associated with severity of bleeding or functional outcome in patients with SAH. This finding was discovered after performing a multivariate analysis adjusting for age where older age was associated with worsened severity and outcome.
authors.affiliation: Departments of *Neurosurgery and ‡Health Sciences Research, Division of Biomedical Statistics and Informatics, §Mayo School of Health Sciences, Mayo Clinic College of Medicine, Departments of ¶Radiology, ‖Neurology, #Critical Care, Mayo Clinic, Jacksonville, Florida; **Department of Neurological Surgery, Baptist Health System, Jacksonville, Florida.
authors.forename: Rabih G
authors.initials: RG
authors.lastname: Tawk
authors.forename: Sanjeet S
authors.initials: SS
authors.lastname: Grewal
authors.forename: Michael G
authors.initials: MG
authors.lastname: Heckman
authors.forename: Ramon
authors.initials: R
authors.lastname: Navarro
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Ferguson
authors.forename: Emily L
authors.initials: EL
authors.lastname: Starke
authors.forename: Bhupendra
authors.initials: B
authors.lastname: Rawal
authors.forename: Ricardo
authors.initials: R
authors.lastname: Hanel
authors.forename: David
authors.initials: D
authors.lastname: Miller
authors.forename: Robert E
authors.initials: RE
authors.lastname: Wharen
authors.forename: William D
authors.initials: WD
authors.lastname: Freeman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D055815:Young Adult