Jang, Shin Yi; Shin, Yong-Il; Kim, Deog Young; Sohn, Min Kyun; Lee, Jongmin; Lee, Sam-Gyu; Oh, Gyung-Jae; Lee, Yang-Soo; Joo, Min Cheol; Han, Eun Young; Chang, Won Hyuk; Kang, Chung; Kim, Yun-Hee
BMJ open
2015NA ; 5 ( 12 ) :e008712.
PMID : 26685024
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Jang, Shin Yi - Heart Vascular Stroke Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Korea.
Shin, Yong-Il - Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Pusan, Korea.
Kim, Deog Young - Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
Sohn, Min Kyun - Department of Rehabilitation Medicine, School of Medicine, Chungnam National University, Daejeon, Korea.
Lee, Jongmin - Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea.
Lee, Sam-Gyu - Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School, Gwangju, Korea.
Oh, Gyung-Jae - Department of Preventive Medicine, Wonkwang University School of Medicine, Iksan, Korea.
Lee, Yang-Soo - Department of Rehabilitation Medicine, Kyungpook National University School of Medicine, Kyungpook National University Hospital, Daegu, Korea.
Joo, Min Cheol - Department of Rehabilitation Medicine, Wonkwang University School of Medicine, Iksan, Korea.
Han, Eun Young - Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University, School of Medicine, Jeju, Korea.
Chang, Won Hyuk - Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kang, Chung - Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kim, Yun-Hee - Heart Vascular Stroke Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Korea Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
ABSTRACT
OBJECTIVES: We examined whether obesity based on body mass index (BMI) was a predictor of functional independence measure (FIM) at 6 months after ischaemic stroke onset while adjusting for stroke risk factors and covariates and stratifying by age group. DESIGN: This is an interim report of the Korean Stroke Cohort for Functioning and Rehabilitation that was designed as a nested case study within a nationwide hospital-based cohort. SETTING: We identified all patients who were admitted to nine representative hospitals in Korea from 2012 until 2014 under a diagnosis of acute first-ever ischaemic stroke. The hospitals were selected from the metropolitan district, mid-sized cities and a small-sized city. PARTICIPANTS: The sample included 2057 patients with acute ischaemic stroke who were at least 18 years old. PRIMARY AND SECONDARY OUTCOME MEASURES: We divided participants into two age levels (<65 and ??65 years). Participants were classified into five groups according to their baseline BMI at admission: underweight (BMI<18.5), normal (18.5 ??BMI<23), overweight (23 ??BMI<25), obese (25 ??BMI<30) and extremely obese (30 ??BMI).
RESULTS: The proportion of patients who were aged ??65 years was 55.0%. The proportions of underweight, normal, overweight, obese and extremely obese patients were 2.6%, 24.3%, 29.6%, 37.2% and 6.3%, respectively, in the <65 years group and 5.5%, 34.5%, 27.9%, 28.8% and 3.3%, respectively, in the ??65 years group. In a multiple linear regression, the 6-month FIM after stroke in the elderly group was significantly associated with being extremely obese (7.95, p<0.05) after adjusting for confounding variables. In the <65 years group, the 6-month FIM was not associated with any weight category.
CONCLUSIONS: This nationwide hospital-based cohort study showed that extreme obesity is a predictor of a good 6-month FIM, especially in patients with ischaemic stroke who are at least 65 years of age. CI - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
keyword
body mass index; elderly; functional independence measure; ischemic stroke; obese
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