No obesity paradox in out-of-hospital cardiac arrest: Data from the Swedish registry of cardiopulmonary resuscitation.
Diabetes
Obesity
Out-of-hospital cardiac arrest
Survival
Journal
Resuscitation plus
ISSN: 2666-5204
Titre abrégé: Resusc Plus
Pays: Netherlands
ID NLM: 101774410
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
21
05
2023
revised:
25
07
2023
accepted:
28
07
2023
medline:
21
8
2023
pubmed:
21
8
2023
entrez:
21
8
2023
Statut:
epublish
Résumé
Although an "obesity paradox", which states an increased chance of survival for patients with obesity after myocardial infarction has been proposed, it is less clear whether this phenomenon even exists in patients suffering out-of-hospital cardiac arrest (OHCA) and if diabetes, which is often associated with obesity, implies an additional risk. To investigate if and how obesity, with or without diabetes, affects the survival of patients with OHCA. This study included 55,483 patients with OHCA reported to the Swedish Registry of Cardiopulmonary Resuscitation between 2010 and 2020. Patients were classified in five groups: obesity only (Ob), type 1 diabetes only (T1D), type 2 diabetes only (T2D), obesity and any diabetes (ObD), or belonging to the group other (OTH). Patient characteristics and outcomes were studied using descriptive statistics, logistic, and Cox proportional regression. Obesity only was found in 2.7% of the study cohort, while 3.2% had obesity and any type of diabetes. Ob patients were significantly younger than all other patients (p ≤ 0.001); the 30 day-survival was 9.6% in Ob, and 10.6%, 7.3%, 6.9%, and 12.7% in T1D, T2D, ObD, and OTH, respectively, with OR (95% CI) of 0.69 (0.57-0.82), 0.78 (0.56-1.05), 0.65 (0.59-0.71), and 0.55 (0.45-0.66) for Ob, T1D, T2D, and ObD, respectively (reference group OTH). No time-related trends in 30-days survival were found. Obesity was present in 6% of the population and was associated with younger age and a 30% reduction in survival; a combination of obesity and diabetes further reduced the survival rate.
Sections du résumé
Background
UNASSIGNED
Although an "obesity paradox", which states an increased chance of survival for patients with obesity after myocardial infarction has been proposed, it is less clear whether this phenomenon even exists in patients suffering out-of-hospital cardiac arrest (OHCA) and if diabetes, which is often associated with obesity, implies an additional risk.
Objective
UNASSIGNED
To investigate if and how obesity, with or without diabetes, affects the survival of patients with OHCA.
Methods
UNASSIGNED
This study included 55,483 patients with OHCA reported to the Swedish Registry of Cardiopulmonary Resuscitation between 2010 and 2020. Patients were classified in five groups: obesity only (Ob), type 1 diabetes only (T1D), type 2 diabetes only (T2D), obesity and any diabetes (ObD), or belonging to the group other (OTH). Patient characteristics and outcomes were studied using descriptive statistics, logistic, and Cox proportional regression.
Results
UNASSIGNED
Obesity only was found in 2.7% of the study cohort, while 3.2% had obesity and any type of diabetes. Ob patients were significantly younger than all other patients (p ≤ 0.001); the 30 day-survival was 9.6% in Ob, and 10.6%, 7.3%, 6.9%, and 12.7% in T1D, T2D, ObD, and OTH, respectively, with OR (95% CI) of 0.69 (0.57-0.82), 0.78 (0.56-1.05), 0.65 (0.59-0.71), and 0.55 (0.45-0.66) for Ob, T1D, T2D, and ObD, respectively (reference group OTH). No time-related trends in 30-days survival were found.
Conclusion
UNASSIGNED
Obesity was present in 6% of the population and was associated with younger age and a 30% reduction in survival; a combination of obesity and diabetes further reduced the survival rate.
Identifiants
pubmed: 37601410
doi: 10.1016/j.resplu.2023.100446
pii: S2666-5204(23)00089-9
pmc: PMC10432953
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100446Informations de copyright
© 2023 The Author(s).
Déclaration de conflit d'intérêts
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Références
Resuscitation. 2004 Dec;63(3):233-49
pubmed: 15582757
Eur Heart J. 2021 Mar 14;42(11):1094-1106
pubmed: 33543259
Eur Heart J. 2015 Jul 14;36(27):1754-61
pubmed: 25920404
Intensive Care Med. 2018 May;44(5):665-666
pubmed: 29352325
BMC Bioinformatics. 2008 Jul 11;9:307
pubmed: 18620558
Eur Heart J. 2022 Dec 7;43(46):4817-4829
pubmed: 35924401
Resuscitation. 2021 Apr;161:61-79
pubmed: 33773833
Am J Emerg Med. 2018 Jul;36(7):1270-1279
pubmed: 29678294
Indian J Crit Care Med. 2020 Nov;24(11):1077-1080
pubmed: 33384514
J Crit Care. 2022 Jun;69:154025
pubmed: 35339901
N Engl J Med. 2015 Jun 11;372(24):2307-15
pubmed: 26061835
Scand J Trauma Resusc Emerg Med. 2021 Jan 28;29(1):24
pubmed: 33509251
Circulation. 2008 Jul 22;118(4):389-96
pubmed: 18606920
Circulation. 2018 Mar 20;137(12):e67-e492
pubmed: 29386200
Circ Res. 2016 May 27;118(11):1723-35
pubmed: 27230638
Am J Med. 2005 Sep;118(9):978-80
pubmed: 16164883
Cell Metab. 2022 Jan 4;34(1):11-20
pubmed: 34986330
Clin Nutr ESPEN. 2018 Apr;24:47-53
pubmed: 29576362
J Diabetes Res. 2018 Nov 4;2018:3407306
pubmed: 30525052
Clin Cardiol. 2018 Jan;41(1):46-50
pubmed: 29355997
JAMA. 2012 Aug 8;308(6):581-90
pubmed: 22871870