Being Overweight or Obese is Associated with Lesser Disability after Intracerebral Hemorrhage (P7.139)

OBJECTIVE: To examine whether overweight and obese patients with ICH have better functional outcomes at 3 months. BACKGROUND: Among outpatients with chronic heart failure, a higher BMI has been associated with a decreased risk of death and hospitalization. Similarly, overweight patients admitted to an ICU have been found to have improved survival both at 30 days and 1 year after admission. These counterintuitive observations are examples of the “obesity paradox”. DESIGN/METHODS: From September 2009 to December 2012, 286 patients with spontaneous intracerebral hemorrhage (ICH) admitted to the Neurological ICU at Columbia University Medical Center were prospectively enrolled in the ICH Outcomes Project (ICHOP). Information on both BMI and outcome at 3 months was available in 202 patients. Patients were divided into two groups - overweight or obese (BMI >=25 kg/m2) and not overweight (<25 kg/m2). Primary outcome was defined as good Modified Rankin score (mRS<=3) versus poor (mRS 4-6). RESULTS: The median age was 62 years (interquartile range [IQR] 50-78); the median BMI 26.8 kg/m2 (IQR 23.7-30.4); median APACHEII-score 14 (IQR 8-21), and the median ICH score was 2 (IQR 1-3). Among patients with a BMI <25 kg/m2, 76% (53/70) had a poor outcome, and among the patients with a BMI蠅25 kg/m2 61% (80/132, p=0.04) had a poor outcome. After adjusting for age, APACHE-2, and ICH-score; BMI蠅25 was associated with 0.45 times lower odds of a poor outcome at 3 months (adjusted Odds Ratio 0.45, 95%-Confidence Interval: 0.23-0.88, p=0.02). CONCLUSIONS: Among ICH-patients, a BMI 蠅25 kg/m2 was associated with half the odds of a poor functional outcome at 3 months after adjustment for established outcome predictors. In this cohort of ICH patients, the obesity paradox was associated for the first time with functional outcomes. Study Supported by: None Disclosure: Dr. Dangayach has nothing to disclose. Dr. De Marchis has nothing to disclose. Dr. Grewal has nothing to disclose. Dr. Bruce has nothing to disclose. Dr. Chhatlani has nothing to disclose. Dr. Falo has nothing to disclose. Dr. Connolly has nothing to disclose. Dr. Agarwal has nothing to disclose. Dr. Claassen has nothing to disclose. Dr. Schmidt has nothing to disclose. Dr. Mayer has received personal compensation for activities with Actelion, Baxter, Biogen Idec, Codman/Johnson & Johnson Company, CSL Behring, Cornerstone Therapeutics, CR Bard, Novartis, Orsan Technologies, Pfizer Inc, Sage Therapeutics, and Stryker. Dr. Mayer has received research support from Non-Invasive Medical Systems, Inc., and General Electric.