Abstract 206: An Obesity Paradox in Acute Decompensated Heart Failure
Background: Prior studies on heart failure (HF) have shown that body mass index (BMI) is inversely associated with mortality. The aim of this study was to investigate the impact of morbid obesity (BMI > 40 kg/m2) on in-hospital mortality in patients presenting with Acute decompensated heart failure (ADHF).
Methods: The Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project was analyzed for acute HF hospitalizations across the United States. A total number of 966,167 hospitalized patients with ADHF in 2009 were reviewed.
Results: Morbidly obese patients constituted 13.4% of all patients with ADHF. Analysis of the unadjusted data revealed that morbidly obese patients compared with those not morbidly obese were less likely to die during hospitalization (OR 0.55, %95CI 0.53-0.57, P<0.0001). Cox proportional hazards regression was used to estimate the overall probability of in-hospital death with adjustments for age, sex, race, Elixhauser comorbidities, primary payer, hospital location, hospital teaching status, hospital bed-size, and total hospital admissions. The adjusted hazard of in-hospital death (HR 0.87, p< <.0001) indicates that there was statistically significant difference in the risk of in-hospital death associated with being morbidly obese.
Conclusions: In this cohort of hospitalized patients with ADHF, higher BMI was associated with lower in-hospital mortality risk. The relationship between BMI and adverse outcomes in HF appears to be complex and consistent with the phenomenon of the “obesity paradox.”
Author Disclosures: M. Khoshchehreh: None. S. Malik: None.
- © 2014 by American Heart Association, Inc.