西安地区急性卒中患者体质量指数与早期预后的关系研究

Relationship between Body Mass Index and Early Prognosis in Patients with Acute Stroke in Xi’an Region

目的:探讨西安地区急性卒中患者体质量指数(BMI)与早期预后的关系。方法:纳入西安市4所三级甲等医院2015年1~12月连续入院的急性卒中患者的临床资料,比较分析不同BMI范围(按BMI分为体质量过低组、体质量正常组、超重组及肥胖组)患者的临床特征,随访90 d的结局事件(包括卒中复发、死亡和预后不良)。通过单因素和多因素Logistic回归分析,探讨西安地区急性卒中患者BMI与早期预后的关系。结果:最终纳入急性卒中患者2692例,平均年龄(63.58±12.46)岁。90 d随访发现,体质量过低组死亡率明显较高(体质量过低组12.12%,体质量正常组3.70%,超重组4.42%,肥胖组2.88%,P<0.001);但各组间90 d预后不良发生率和卒中复发率差异均无统计学意义(P=0.113,P=0.495)。校正相关混杂因素后,多因素Logistic回归分析显示,体质量过低是西安地区急性卒中患者90 d死亡的独立危险因素(OR=3.72,95%CI1.54~9.00,P=0.004),但不是90 d卒中复发和预后不良的独立危险因素(P>0.05)。结论:体质量过低是西安地区急性卒中患者早期死亡的独立危险因素。

Objective:To investigate the relationship between body mass index(BMI)and early prognosis in patients with acute stroke in the Xi’an region.Methods:Clinical data of acute stroke patients who were consecutively admitted to 4 tertiary grade A hospitals in the Xi’an area from January 2015 to December 2015 were collected.The clinical characteristics of acute stroke patients with different ranges of BMI(classified as groups underweight,normal weight,overweight,and obese)were compared,and the outcome events(including stroke recurrence,death,and poor prognosis)were followed up for 90 days.Univariate and multivariate Logistic regression analysis was performed to investigate the relationship between BMI and early prognosis in these patients.Results:A total of 2692 acute stroke patients were enrolled in this study,with a mean age of(63.58±12.46)years.Follow-up at 90 d revealed significantly higher mortality rate in the low BMI group(12.12%for low vs.3.70%for normal,4.42%for overweight,and 2.88%for obese)with statistically significant differences(P<0.001),but there were no statistically significant differences between the groups in poor prognosis rate and stroke recurrence rate at 90 d(P=0.113 and P=0.495).After adjusting for relevant confounders,multivariate Logistic regression analysis showed that low BMI was an independent risk factor for 90 d mortality in acute stroke patient in the Xi’an area(OR=3.72,95%CI 1.54~9.00,P=0.004)but was not an independent risk factor for stroke recurrence and poor prognosis at 90 d(P>0.05).Conclusion:Low BMI was an independent risk factor for early mortality in acute stroke patient in the Xi’an region.