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Obesity may predict stroke outcomes in black adults
Black adults with obesity have markedly higher risk for experiencing poor outcomes after an intracerebral hemorrhage vs. white adults, according to findings published in Obesity Science & Practice.
“Although race did not influence the overall study results, within the nonwhite population, obesity was associated with poor hospital discharge disposition outcome, a result that was not observed in patients with normal weight and overweight,” Ifeanyi O. Iwuchukwu, MD, an assistant professor of neuroscience at Louisiana State University, and colleagues wrote. “Interestingly, this observation was not detected in the white population group.”
Iwuchukwu and colleagues analyzed data from 428 patients admitted to Ochsner Medical Center in New Orleans between November 2012 and March 2016 with a diagnosis of spontaneous intracerebral hemorrhage (50% women; 43.7% black). Researchers reviewed all neuroimaging studies (initial and follow-up) and all records of discharge locations. Outcome measures were hematoma expansion at 24 hours (defined as at least 30% expansion in intracranial hemorrhage volume) and discharge disposition. Researchers defined a discharge disposition to home and inpatient acute rehabilitation as a good outcome, and discharge to a nursing facility, long-term acute care facility and death were defined as poor outcomes.
Researchers found that good outcome discharge disposition differed across BMI categories; however, BMI did not influence hematoma expansion outcomes.
Patients with obesity diagnosed with an intracerebral hemorrhage were more likely overall to experience a poor disposition outcome vs. patients with normal weight or overweight. ORs for poor disposition outcomes for patients with obesity were 0.26 vs. patients with normal weight (95% CI, 0.115-0.593) and 3.79 vs. those with overweight (95% CI, 1.68-8.52), according to researchers.
Overall, race did not influence disposition or hematoma expansion outcomes, but nonwhite adults with obesity were more likely to experience a poor disposition outcome vs. nonwhite adults of normal weight (OR = 6.84; 95% CI, 2.12-22.22) and nonwhite adults with overweight (OR = 8.45; 95% CI, 2.6-27.49).
“Importantly, our study differs as our study population included a large African-American population compared to [a] prior study, which was primarily an Asian population in South Korea,” Iwuchukwu said in a press release. “Our study is significant because, epidemiologically, [intracerebral hemorrhage] is a common type of stroke among 30- to 50-year-old African-Americans, and obesity was an independent predictor of outcomes in our study cohort.”
The researchers noted that prospective research is needed to examine the role of excess adiposity and race on acute and long-term health outcomes after intracerebral hemorrhage. – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.