title: The impact of body mass index on patient survival after therapeutic hypothermia after resuscitation.
abstract: OBJECTIVE
  Therapeutic hypothermia improves survival in patients after cardiac arrest, yet the impact of body mass index (BMI) on survival is lesser known. We hypothesized that nonobese patients would have greater survival post-therapeutic hypothermia than obese patients.
  
  
  METHODS
  We retrospectively evaluated 164 patients who underwent therapeutic hypothermia after resuscitation for cardiac arrest from January 2012 to September 2014. Logistic regression analysis was used to assess for survival based upon BMI and comorbidities (odds ratio, 95% confidence interval).
  
  
  RESULTS
  Forty-one percent of patients were obese. Obese patients presented less frequently with ventricular fibrillation (P=.046) but had similar rates of pulseless electrical activity (P=.479) and ventricular tachycardia (P=.262) to nonobese patients. In multivariable analysis, BMI less than 30 kg/m(2), hypertension, presence of pacemaker/implantable cardioverter-defibrillator, high glomerular filtration rate, and low neuron-specific enolase were all associated with increased survival post-therapeutic hypothermia, respectively: 0.36 (0.16-0.78), 0.28 (0.12-0.66), 0.23 (0.08-0.62), 0.25 (0.11-0.56), and 0.37 (0.14-0.96). Other comorbidities demonstrated no association with survival.
  
  
  CONCLUSIONS
  Body mass index at least 30 kg/m(2) compared with BMI less than 30 kg/m(2) was a significant risk factor for mortality post-therapeutic hypothermia protocol. Absence of history of hypertension, lack of pacemaker/implantable cardioverter-defibrillator, high neuron-specific enolase, and renal disease had greater associations with death. Larger studies will be needed to validate these findings.
authors.affiliation: Division of Cardiology, University of Colorado, Aurora, CO. Electronic address: Khadijah.breathett@ucdenver.edu.
authors.forename: Khadijah
authors.initials: K
authors.lastname: Breathett
authors.affiliation: Division of Cardiology, Brigham and Women's Hospital, Boston, MA.
authors.forename: Nishaki
authors.initials: N
authors.lastname: Mehta
authors.affiliation: Center for Biostatistics, The Ohio State University, Columbus, OH.
authors.forename: Vedat
authors.initials: V
authors.lastname: Yildiz
authors.affiliation: Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Erik
authors.initials: E
authors.lastname: Abel
authors.affiliation: Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Ruchika
authors.initials: R
authors.lastname: Husa
mesh_terms: D015992:Body Mass Index; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006323:Heart Arrest / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors