Racial differences in intracerebral haemorrhage outcomes in patients with obesity

Summary Objective This study was conducted to determine the role of obesity and race in intracerebral haemorrhage (ICH) outcomes. Methods The Get with the guideline‐Stroke database was queried for all admitted patients with spontaneous ICH. Secondary causes of ICH were excluded. Body mass index (BMI...

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Published inObesity science & practice Vol. 4; no. 3; pp. 268 - 275
Main Authors Iwuchukwu, I., Mahale, N., Ryder, J., Hsieh, B., Jennings, B., Nguyen, D., Cornwell, K., Beyl, R., Zabaleta, J., Sothern, M.
Format Journal Article
LanguageEnglish
Published United States John Wiley & Sons, Inc 01.06.2018
John Wiley and Sons Inc
Subjects
Blood pressure
Body mass index
Body weight
Centers for Disease Control and Prevention
Congestive heart failure
demographic statistics
Demography
Diabetes
Diabetes mellitus
Family medical history
females
Gender
Heart failure
Hematoma
Hemorrhage
hospitals
Hypertension
intracerebral haemorrhage
Medical imaging
Multivariate analysis
Nursing
Obesity
Original
outcomes
Overweight
Patients
Race
Racial differences
racial diversity
Rehabilitation
Stroke
Studies
United States > US
intracerebral haemorrhage
outcomes
racial diversity
obesity
Online AccessGet full text
ISSN2055-2238
2055-2238
DOI10.1002/osp4.167

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Abstract Summary Objective This study was conducted to determine the role of obesity and race in intracerebral haemorrhage (ICH) outcomes. Methods The Get with the guideline‐Stroke database was queried for all admitted patients with spontaneous ICH. Secondary causes of ICH were excluded. Body mass index (BMI) was classified using the Center for Disease Control guidelines. Race was classified as White or non‐White. Demographics, clinical, imaging data were retrieved. Outcome measures were hematoma expansion at 24 h and discharge disposition. Results A total of 428 patients were included in our analysis. Female gender, past history of congestive heart failure, diabetes mellitus, HbA1c, blood pressure, ICH volume, ICH location, intraventricular haemorrhage and hospital length of stay deferred across BMI categories. On multivariate analysis, along with obese categories, age, ICH location and ICH volume were independent predictors of poor outcomes (hematoma expansion and poor discharge disposition). After adjusting for these variables, obesity remained a predictor of poor disposition outcome compared with normal and overweight subjects; Normal vs. Obese OR 0.26 CI 0.115–0.593 p = 0.0014; Obese vs. Overweight OR 3.79 CI 1.68–8.52 p = 0.0013. Nonetheless, obesity did not influence hematoma expansion. Overall, BMI‐race classification did not influence outcomes. However, among non‐Whites, the obese category had higher odds of a poor disposition outcome than normal (OR 6.84 CI 2.12–22.22 p = 0.0013) or overweight (OR 8.45 CI 2.6–27.49 p = 0.0004) categories. Conclusion An obesity paradox in ICH was not observed in our cohort. In the non‐White population, patients with obesity were likely to be associated with poor disposition outcome. Similar findings were not observed in White population.
AbstractList This study was conducted to determine the role of obesity and race in intracerebral haemorrhage (ICH) outcomes. The Get with the guideline-Stroke database was queried for all admitted patients with spontaneous ICH. Secondary causes of ICH were excluded. Body mass index (BMI) was classified using the Center for Disease Control guidelines. Race was classified as White or non-White. Demographics, clinical, imaging data were retrieved. Outcome measures were hematoma expansion at 24 h and discharge disposition. A total of 428 patients were included in our analysis. Female gender, past history of congestive heart failure, diabetes mellitus, HbA1c, blood pressure, ICH volume, ICH location, intraventricular haemorrhage and hospital length of stay deferred across BMI categories. On multivariate analysis, along with obese categories, age, ICH location and ICH volume were independent predictors of poor outcomes (hematoma expansion and poor discharge disposition). After adjusting for these variables, obesity remained a predictor of poor disposition outcome compared with normal and overweight subjects; Normal vs. Obese OR 0.26 CI 0.115-0.593 p = 0.0014; Obese vs. Overweight OR 3.79 CI 1.68-8.52 p = 0.0013. Nonetheless, obesity did not influence hematoma expansion. Overall, BMI-race classification did not influence outcomes. However, among non-Whites, the obese category had higher odds of a poor disposition outcome than normal (OR 6.84 CI 2.12-22.22 p = 0.0013) or overweight (OR 8.45 CI 2.6-27.49 p = 0.0004) categories. An obesity paradox in ICH was not observed in our cohort. In the non-White population, patients with obesity were likely to be associated with poor disposition outcome. Similar findings were not observed in White population.
Summary Objective This study was conducted to determine the role of obesity and race in intracerebral haemorrhage (ICH) outcomes. Methods The Get with the guideline‐Stroke database was queried for all admitted patients with spontaneous ICH. Secondary causes of ICH were excluded. Body mass index (BMI) was classified using the Center for Disease Control guidelines. Race was classified as White or non‐White. Demographics, clinical, imaging data were retrieved. Outcome measures were hematoma expansion at 24 h and discharge disposition. Results A total of 428 patients were included in our analysis. Female gender, past history of congestive heart failure, diabetes mellitus, HbA1c, blood pressure, ICH volume, ICH location, intraventricular haemorrhage and hospital length of stay deferred across BMI categories. On multivariate analysis, along with obese categories, age, ICH location and ICH volume were independent predictors of poor outcomes (hematoma expansion and poor discharge disposition). After adjusting for these variables, obesity remained a predictor of poor disposition outcome compared with normal and overweight subjects; Normal vs. Obese OR 0.26 CI 0.115–0.593 p = 0.0014; Obese vs. Overweight OR 3.79 CI 1.68–8.52 p = 0.0013. Nonetheless, obesity did not influence hematoma expansion. Overall, BMI‐race classification did not influence outcomes. However, among non‐Whites, the obese category had higher odds of a poor disposition outcome than normal (OR 6.84 CI 2.12–22.22 p = 0.0013) or overweight (OR 8.45 CI 2.6–27.49 p = 0.0004) categories. Conclusion An obesity paradox in ICH was not observed in our cohort. In the non‐White population, patients with obesity were likely to be associated with poor disposition outcome. Similar findings were not observed in White population.
This study was conducted to determine the role of obesity and race in intracerebral haemorrhage (ICH) outcomes.OBJECTIVEThis study was conducted to determine the role of obesity and race in intracerebral haemorrhage (ICH) outcomes.The Get with the guideline-Stroke database was queried for all admitted patients with spontaneous ICH. Secondary causes of ICH were excluded. Body mass index (BMI) was classified using the Center for Disease Control guidelines. Race was classified as White or non-White. Demographics, clinical, imaging data were retrieved. Outcome measures were hematoma expansion at 24 h and discharge disposition.METHODSThe Get with the guideline-Stroke database was queried for all admitted patients with spontaneous ICH. Secondary causes of ICH were excluded. Body mass index (BMI) was classified using the Center for Disease Control guidelines. Race was classified as White or non-White. Demographics, clinical, imaging data were retrieved. Outcome measures were hematoma expansion at 24 h and discharge disposition.A total of 428 patients were included in our analysis. Female gender, past history of congestive heart failure, diabetes mellitus, HbA1c, blood pressure, ICH volume, ICH location, intraventricular haemorrhage and hospital length of stay deferred across BMI categories. On multivariate analysis, along with obese categories, age, ICH location and ICH volume were independent predictors of poor outcomes (hematoma expansion and poor discharge disposition). After adjusting for these variables, obesity remained a predictor of poor disposition outcome compared with normal and overweight subjects; Normal vs. Obese OR 0.26 CI 0.115-0.593 p = 0.0014; Obese vs. Overweight OR 3.79 CI 1.68-8.52 p = 0.0013. Nonetheless, obesity did not influence hematoma expansion. Overall, BMI-race classification did not influence outcomes. However, among non-Whites, the obese category had higher odds of a poor disposition outcome than normal (OR 6.84 CI 2.12-22.22 p = 0.0013) or overweight (OR 8.45 CI 2.6-27.49 p = 0.0004) categories.RESULTSA total of 428 patients were included in our analysis. Female gender, past history of congestive heart failure, diabetes mellitus, HbA1c, blood pressure, ICH volume, ICH location, intraventricular haemorrhage and hospital length of stay deferred across BMI categories. On multivariate analysis, along with obese categories, age, ICH location and ICH volume were independent predictors of poor outcomes (hematoma expansion and poor discharge disposition). After adjusting for these variables, obesity remained a predictor of poor disposition outcome compared with normal and overweight subjects; Normal vs. Obese OR 0.26 CI 0.115-0.593 p = 0.0014; Obese vs. Overweight OR 3.79 CI 1.68-8.52 p = 0.0013. Nonetheless, obesity did not influence hematoma expansion. Overall, BMI-race classification did not influence outcomes. However, among non-Whites, the obese category had higher odds of a poor disposition outcome than normal (OR 6.84 CI 2.12-22.22 p = 0.0013) or overweight (OR 8.45 CI 2.6-27.49 p = 0.0004) categories.An obesity paradox in ICH was not observed in our cohort. In the non-White population, patients with obesity were likely to be associated with poor disposition outcome. Similar findings were not observed in White population.CONCLUSIONAn obesity paradox in ICH was not observed in our cohort. In the non-White population, patients with obesity were likely to be associated with poor disposition outcome. Similar findings were not observed in White population.
OBJECTIVE: This study was conducted to determine the role of obesity and race in intracerebral haemorrhage (ICH) outcomes. METHODS: The Get with the guideline‐Stroke database was queried for all admitted patients with spontaneous ICH. Secondary causes of ICH were excluded. Body mass index (BMI) was classified using the Center for Disease Control guidelines. Race was classified as White or non‐White. Demographics, clinical, imaging data were retrieved. Outcome measures were hematoma expansion at 24 h and discharge disposition. RESULTS: A total of 428 patients were included in our analysis. Female gender, past history of congestive heart failure, diabetes mellitus, HbA1c, blood pressure, ICH volume, ICH location, intraventricular haemorrhage and hospital length of stay deferred across BMI categories. On multivariate analysis, along with obese categories, age, ICH location and ICH volume were independent predictors of poor outcomes (hematoma expansion and poor discharge disposition). After adjusting for these variables, obesity remained a predictor of poor disposition outcome compared with normal and overweight subjects; Normal vs. Obese OR 0.26 CI 0.115–0.593 p = 0.0014; Obese vs. Overweight OR 3.79 CI 1.68–8.52 p = 0.0013. Nonetheless, obesity did not influence hematoma expansion. Overall, BMI‐race classification did not influence outcomes. However, among non‐Whites, the obese category had higher odds of a poor disposition outcome than normal (OR 6.84 CI 2.12–22.22 p = 0.0013) or overweight (OR 8.45 CI 2.6–27.49 p = 0.0004) categories. CONCLUSION: An obesity paradox in ICH was not observed in our cohort. In the non‐White population, patients with obesity were likely to be associated with poor disposition outcome. Similar findings were not observed in White population.
ObjectiveThis study was conducted to determine the role of obesity and race in intracerebral haemorrhage (ICH) outcomes.MethodsThe Get with the guideline‐Stroke database was queried for all admitted patients with spontaneous ICH. Secondary causes of ICH were excluded. Body mass index (BMI) was classified using the Center for Disease Control guidelines. Race was classified as White or non‐White. Demographics, clinical, imaging data were retrieved. Outcome measures were hematoma expansion at 24 h and discharge disposition.ResultsA total of 428 patients were included in our analysis. Female gender, past history of congestive heart failure, diabetes mellitus, HbA1c, blood pressure, ICH volume, ICH location, intraventricular haemorrhage and hospital length of stay deferred across BMI categories. On multivariate analysis, along with obese categories, age, ICH location and ICH volume were independent predictors of poor outcomes (hematoma expansion and poor discharge disposition). After adjusting for these variables, obesity remained a predictor of poor disposition outcome compared with normal and overweight subjects; Normal vs. Obese OR 0.26 CI 0.115–0.593 p = 0.0014; Obese vs. Overweight OR 3.79 CI 1.68–8.52 p = 0.0013. Nonetheless, obesity did not influence hematoma expansion. Overall, BMI‐race classification did not influence outcomes. However, among non‐Whites, the obese category had higher odds of a poor disposition outcome than normal (OR 6.84 CI 2.12–22.22 p = 0.0013) or overweight (OR 8.45 CI 2.6–27.49 p = 0.0004) categories.ConclusionAn obesity paradox in ICH was not observed in our cohort. In the non‐White population, patients with obesity were likely to be associated with poor disposition outcome. Similar findings were not observed in White population.
Author Mahale, N.
Jennings, B.
Nguyen, D.
Beyl, R.
Cornwell, K.
Sothern, M.
Iwuchukwu, I.
Hsieh, B.
Zabaleta, J.
Ryder, J.
AuthorAffiliation 3 Institute of Translation Research Ochsner Clinic Foundation New Orleans LA USA
4 Ochsner Clinical School University of Queensland New Orleans LA USA
1 Department of Neurocritical Care, Neurology and Neurosurgery, Ochsner Medical Center/Ochsner Clinical School University of Queensland New Orleans LA USA
8 Department of Pediatrics and Stanley S. Scott Cancer Center Louisiana State University Health Sciences Center New Orleans LA USA
6 School of Public Health Louisiana State University Health Sciences Center New Orleans LA
2 Neuroscience Center of Excellence Louisiana State University Health Science Center New Orleans LA USA
7 Department of Biostatistics Pennington Biomedical Research Center Baton Rouge LA
9 Department of Pediatrics, School of Medicine and School of Public Health Louisiana State University Health Sciences Center New Orleans LA USA
5 Department of Neurology Ochsner Medical Center New Orleans LA USA
AuthorAffiliation_xml – name: 1 Department of Neurocritical Care, Neurology and Neurosurgery, Ochsner Medical Center/Ochsner Clinical School University of Queensland New Orleans LA USA
– name: 7 Department of Biostatistics Pennington Biomedical Research Center Baton Rouge LA
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Issue 3
Keywords intracerebral haemorrhage
outcomes
racial diversity
obesity
Language English
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Snippet Summary Objective This study was conducted to determine the role of obesity and race in intracerebral haemorrhage (ICH) outcomes. Methods The Get with the...
This study was conducted to determine the role of obesity and race in intracerebral haemorrhage (ICH) outcomes. The Get with the guideline-Stroke database was...
ObjectiveThis study was conducted to determine the role of obesity and race in intracerebral haemorrhage (ICH) outcomes.MethodsThe Get with the...
This study was conducted to determine the role of obesity and race in intracerebral haemorrhage (ICH) outcomes.OBJECTIVEThis study was conducted to determine...
OBJECTIVE: This study was conducted to determine the role of obesity and race in intracerebral haemorrhage (ICH) outcomes. METHODS: The Get with the...
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SubjectTerms Blood pressure
Body mass index
Body weight
Centers for Disease Control and Prevention
Congestive heart failure
demographic statistics
Demography
Diabetes
Diabetes mellitus
Family medical history
females
Gender
Heart failure
Hematoma
Hemorrhage
hospitals
Hypertension
intracerebral haemorrhage
Medical imaging
Multivariate analysis
Nursing
Obesity
Original
outcomes
Overweight
Patients
Race
Racial differences
racial diversity
Rehabilitation
Stroke
Studies
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Title Racial differences in intracerebral haemorrhage outcomes in patients with obesity
URI https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fosp4.167
https://www.ncbi.nlm.nih.gov/pubmed/29951217
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