Study examines outcomes of patients with obesity following intracerebral haemorrhage.
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‘Study reports poor health outcomes following stroke in predominantly African-American versus Caucasian patients with obesity.’
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The retrospective study examined data on 428 patients from the Get with the Guideline-Stroke database. Data included demographics; medical history; clinical, laboratory, and imaging characteristics; BMI and obesity classification; as well as discharge disposition. Fifty percent of the patients were female, 49.1% were non-white (43.7% African-American, 0.9% Asian, 1.9% non-white Hispanic and 2.6% others), and the white population consisted of non-Hispanic whites. 
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The initial results show that several of the variables were different between the BMI categories - gender, histories of congestive heart failure and diabetes, as well as blood pressure measurements and HbA1c. Good outcome discharge disposition differed significantly across BMI categories. Overall comparison of the white and non-white populations showed age, admission systolic blood pressure, anticoagulant use and ICH location were significantly different between the groups. The difference on outcomes where comparisons were performed within each race group was unexpected.
"In the study group, non-white patients with obesity fared worse than non-white patients without obesity," notes Dr. Iwuchukwu. "A similar finding was not observed in white patients with obesity."
Obesity is an established risk factor for cardiovascular disease including acute cerebrovascular disease - acute ischemic and hemorrhagic strokes. Conversely, several previous reports indicated obesity is associated with better outcomes following several acute conditions - heart failure, carotid endarterectomy, sepsis, bypass surgery and vascular surgery. This phenomenon is known as the "obesity paradox."
"Our findings are important as a previous study on outcomes of 'patients with obesity' following hemorrhagic stroke (intracerebral hemorrhage) suggested that obesity was associated with improved outcomes," Iwuchukwu added. "Importantly, our study differs as our study population included a large African-American population compared to the prior study, which was primarily an Asian population in South Korea. Our study is significant because epidemiologically, ICH is a common type of stroke amongst 30-50 year old African-Americans, and obesity was an independent predictor of outcomes in our study cohort."
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"This is the first study to report poor health outcomes following stroke in predominantly African-American versus Caucasian patients with obesity," concludes senior author Dr. Melinda Sothern, Professor and Jim Finks Endowed Chair in Health Promotion at LSU Health New Orleans School of Public Health. "Patients without obesity were less likely to need rehabilitation and more likely to return home following a stroke event. Findings highlight the need to address the nutritional needs of minority populations at high risk for cardiovascular disease in order to reduce the burden of obesity on recovery following stroke."
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Source-Eurekalert