The impact of body mass index on post resuscitation survival after cardiac arrest: A meta-analysis
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Summary BackgroundObservational studies examining the association between body mass index (BMI) and the outcome of cardiac arrest (CA) shows controversial results. MethodsWe reviewed literature for studies assessing the impact of BMI on survival and neurological outcome following CA. Eligible studies were subsequently meta-analyzed and pooled odds ratios and their corresponding 95% confidence intervals for post CA survival and neurological status were derived. ResultsA total of 7 studies with 24,651 patients were evaluable for this meta-analysis. The studies were also categorized by location of the CA and the use of therapeutic hypothermia. Our results suggested that BMI between 25 and 29.9 kgr/m2 had a favorable impact on survival after CA (OR = 1.172, 95% CI, 1.109–1.236) in comparison to normal weight subjects. Likewise, overweight patients presented increased odds for a favorable neurological outcome after CA (OR = 1.112, 95% CI, 1.020–1.213). On the contrary, underweight subjects presented decreased odds of surviving after CA as compared to normal BMI subjects (OR = 0.781, 95% CI, 0.652–0.935). Finally, BMI >30 kgr/m2 was not associated with improved survival or neurological outcome as compared to BMI 18.5–24.9 kgr/m2. ConclusionsOverweight patients have a favorable prognosis after CA in terms of both survival and neurological outcome. This effect was amplified when the analysis is restricted in in-hospital cardiac arrest and in patients non-treated with therapeutic hypothermia.