The association of body mass index with outcomes and targeted temperature management practice in cardiac arrest survivors.
OBJECTIVE
Obesity is a well-known risk factor in various health conditions. We analyzed the association between obesity and clinical outcomes, and its effect on targeted temperature management (TTM) practice for cardiac arrest survivors by calculating and classifying their body mass indexes (BMIs).


METHODS
We conducted a retrospective data analysis of adult comatose cardiac arrest survivors treated with TTM from 2008 to 2015. BMI was calculated and the cohort was divided into four categories based on the cut-off values of 18.5, 23.0, and 27.5kgm-2. The primary outcome was six-month mortality and the secondary outcomes were neurologic outcome at hospital discharge, cooling rate, and rewarming rate.


RESULTS
The study included 468 patients. Poor neurologic outcome at discharge and six-month mortality were reported in 311 (66.5%) and 271 (57.9%) patients, respectively. A multivariate logistic analysis showed that an overweight compared to normal BMI was associated with lower probability of six-month mortality (odds ratio [OR], 0.481; 95% confidence interval [CI], 0.274-0.846; p=0.011) and poor neurologic outcome at discharge (OR, 0.482; 95% CI, 0.258-0.903; p=0.023). BMI correlated with cooling rate (B, -0.073; 95% CI, -0.108 to -0.039; p<0.001), but had no association with rewarming rate (B, 0.003; 95% CI, -0.001-0.008; p=0.058).


CONCLUSIONS
Overweight BMI compared to normal BMI classification was found to be associated with lower six-month mortality and poor neurologic outcome at discharge in cardiac arrest survivors treated with TTM. Higher BMI correlated with a slower induction rate.
Department of Emergency Medicine, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju, Republic of Korea.
Yong Hun
YH
Jung
Department of Emergency Medicine, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju, Republic of Korea. Electronic address: bbukkuk@hanmail.net.
Byung Kook
BK
Lee
Department of Emergency Medicine, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju, Republic of Korea.
Dong Hun
DH
Lee
Department of Emergency Medicine, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju, Republic of Korea.
Sung Min
SM
Lee
Department of Emergency Medicine, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju, Republic of Korea.
Yong Soo
YS
Cho
Department of Emergency Medicine, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju, Republic of Korea.
Kyung Woon
KW
Jeung
D017677:Age Distribution; D000368:Aged; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D015600:Glasgow Coma Scale; D006323:Heart Arrest / Q000150:complications / Q000401:mortality / Q000628:therapy; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology*; D009765:Obesity; D063305:Organ Dysfunction Scores; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications / Q000401:mortality / Q000628:therapy; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D050177:Overweight; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis
Heart arrest; Obesity; Prognosis; Therapeutic hypothermia