Body Mass Index and Hospital Discharge Outcomes After Ischemic Stroke

Abstract

Obesity is a risk factor for vascular disease and has been associated with poorer outcomes in hospitalized patients. To evaluate the relationship between body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) and discharge outcomes among persons hospitalized for ischemic stroke. The relationship between BMI and discharge outcomes was analyzed in 805 consecutive patients with ischemic stroke admitted to a university hospital stroke service. Patients were categorized into 4 BMI categories representing lean, overweight, and class I and class II obesity. Outcome measures analyzed included discharge functional activity, direct discharge to home, and length of hospital stay. The independent effect of BMI on outcome was evaluated with regression analysis, adjusting for other variables known to predict outcome after ischemic stroke. Four hundred fifty-one individuals (56.0%) met study criteria. Mean age was 65 years, and 28.0% were men. In multivariate analysis, the highest BMI category (compared with lowest BMI category) was associated with the least likelihood of being discharged directly home from the hospital stroke service (26% vs 45%, P = .04), and the upper 2 BMI categories (compared with lowest BMI category) were associated with a trend toward extended length of hospital stay (6.3 vs 5.2 days, P = .08). No significant differences in the functional activity outcome were noted across BMI categories. Elevated BMI is associated with a lower likelihood of being discharged home and a trend toward extended hospital stay among patients hospitalized for ischemic stroke. Body mass index at hospital admission had no relation to discharge functional activity after stroke.