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• W2337292402 abstract "Objective: To assess phenomenon of “obesity paradox” in Acute Ischemic Stroke on a national perspective. Background: Obesity is one of the risk factors for AIS, yet studies have found favorable outcomes among obese patients called “obesity paradox”. It is established in hemodialysis, heart failure, myocardial infarction, and acute coronary syndrome etc.; however there is very limited data regarding this in Acute Ischemic Stroke (AIS). Methods: We reviewed Nationwide Inpatient Sample (NIS) database from 2002 to 2012 for adult hospitalization of AIS as a primary diagnosis using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes of 433-437.1. Obesity status was identified by Clinical Classification Software for ICD-9-CM which is developed by NIS. We excluded hospitalizations with endovascular procedures and stratified cohort based on intravenous tissue plasminogen activator (IV-tPA) utilization. We built a hierarchical two level models adjusted for multiple confounding factors. Results: We identified 4,437,448 AIS related hospitalizations, out of which 169,225 (3.8[percnt]) received IV tPA. Amongst IV-tPA group 13,820 (8.2[percnt]) were obese and had lower in-hospital mortality [6.4[percnt] vs. 9.8[percnt]; p<0.001]. This persisted in hierarchical regression analysis [Adjusted OR:0.78; 95[percnt] Confidence-Interval (CI):0.64-0.94; p<0.001]. Similarly, among non IV-tPA group 266,382 (6.3[percnt]) were obese and had lower in-hospital mortality [2.9[percnt] vs. 5.5[percnt]; p<0.001; Adjusted OR: 0.68; 95[percnt] CI:0.64-0.72; p<0.001]. Conclusions: Among patients hospitalized for AIS, obese patients had lower risk adjusted in-hospital mortality. Similar trend persisted among IV-tpa and non IV-tpa group. The association of obesity and better prognosis, also known as the “obesity paradox” holds true for AIS. This is the first study of its kind on the largest all payer database. However, further studies are required to establish causal relationship for this phenomenon. Disclosure: Dr. Lunagariya has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Savani has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Jani has nothing to disclose. Dr. Hussain has nothing to disclose. Dr. Mehta has nothing to disclose." @default.
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• W2337292402 date "2016-04-05" @default.
• W2337292402 modified "2023-10-10" @default.
• W2337292402 title "Obesity Paradox in Patients Hospitalized for Acute Ischemic Stroke: An Analysis of Nationwide Inpatient Sample Data (S47.008)" @default.
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