Body mass index and all-cause mortality in patients with cardiogenic shock: A systematic review and meta-analysis.

Abstract

The association between body mass index (BMI) and all-cause mortality of patients with Cardiogenic Shock (CS) is still controversial. The objective of this analysis is to summarize the available evidence of this association and perform meta-analysis using adjusted estimates. PubMed, Embase and Cochrane databases were systematically searched for eligible studies up to July 2020. Studies were considered eligible if they described the association between BMI and all-cause mortality of patients with CS, and those reporting adjusted estimates were included in the meta-analysis. Three studies were identified and included total 345,281 participants. The pooled hazard ratio of all-cause mortality was 0.88(95% confidence interval (CI): 0.71-1.08, P=0.23) when compared obesity with non-obese. In subgroup analysis, A subgroup analysis based on geographic region showed that obese patients had lower mortality compared with non-obese patients (OR=0.71,95% CI 0.65-0.77, P<0.00001) in USA, developed country and the retrospective study. Heterogeneity was not explained in pre-specified subgroups analysis. Obesity was associated with increased adjusted all-cause mortality of patients with Cardiogenic Shock when compared to non-obese. Unexplained heterogeneity and suboptimal quality of studies limit the strength of the results. This seemingly paradoxical finding needs to be confirmed with further research.