Body mass index and outcomes of in-hospital ventricular tachycardia and ventricular fibrillation arrest
| Autor: | Preston M Schneider, Abu Minhajuddin, Steven M. Bradley, Emily Melikman, Girish P. Joshi, Charles W. Whitten, Tiffany S. Moon, Babatunde O. Ogunnaike |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Defibrillation medicine.medical_treatment Electric Countershock 030204 cardiovascular system & hematology Emergency Nursing Overweight Ventricular tachycardia Body Mass Index Time-to-Treatment 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Humans Cardiopulmonary resuscitation Registries Aged Aged 80 and over Analysis of Variance business.industry 030208 emergency & critical care medicine Odds ratio Middle Aged medicine.disease Survival Analysis Cardiopulmonary Resuscitation Heart Arrest Ventricular fibrillation Ventricular Fibrillation Emergency Medicine Cardiology Tachycardia Ventricular Female medicine.symptom Underweight Cardiology and Cardiovascular Medicine business Body mass index Defibrillators |
| Zdroj: | Resuscitation. 105 |
| ISSN: | 1873-1570 |
| Popis: | Due to higher transthoracic impedance, obese patients may be less likely to be successfully defibrillated from ventricular tachycardia or ventricular fibrillation (VT/VF) arrest. However, the association between patient body mass index (BMI), defibrillation success, and survival outcomes of VT/VF arrest are poorly understood.We evaluated 7110 patients with in-hospital VT/VF arrest at 286 hospitals within the Get With The Guidelines(®)-Resuscitation (GWTG-R) Multicenter Observational Registry between 2006 and 2012. Patients were categorized as underweight (BMI18.5kg/m(2)), normal weight (BMI 18.5-24.9kg/m(2)), over-weight (BMI 25.0-29.9kg/m(2)), obese (BMI 30.0-34.9kg/m(2)), and extremely obese (BMI≥35.0kg/m(2)). Using generalized linear mixed regression, we determined the risk-adjusted relationship between BMI and patient outcomes while accounting for clustering by hospitals. The primary outcome was successful first shock defibrillation (a post-shock rhythm other than VT/VF) with secondary outcomes of return of spontaneous circulation, survival to 24h, and survival to discharge.Among adult patients suffering VT/VF arrest, 304 (4.3%) were underweight, 2061 (29.0%) were normal weight, 2139 (30.1%) were overweight, and 2606 (36.6%) were obese or extremely obese. In a risk-adjusted analysis, we observed no interaction between BMI and energy level for the successful termination of VT/VF with first shock. Furthermore, the risk-adjusted likelihood of successful first shock termination of VT/VF did not differ significantly across BMI categories. Finally, when compared to overweight patients, obese patients had similar risk-adjusted likelihood of survival to hospital discharge (odds ratio 0.786, 95% confidence interval 0.593-1.043).There was no significant difference in the likelihood of successful defibrillation with the first shock attempt among different BMI categories. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect