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Body mass index and outcomes of in-hospital ventricular tachycardia and ventricular fibrillation arrest.

Abstract：

BACKGROUND: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. METHODS: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 (BMI<18.5kg/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. RESULTS: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). CONCLUSIONS:There was no significant difference in the likelihood of successful defibrillation with the first shock attempt among different BMI categories.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Ogunnaike BO,Whitten CW,Minhajuddin A,Melikman E,Joshi GP,Moon TS,Schneider PM,Bradley SM,American Heart Association's Get With The Guidelines(®)-Resuscitation Investigators.

doi

10.1016/j.resuscitation.2016.05.028

subject

Has Abstract

pub_date

2016-08-01 00:00:00

pages

156-60

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(16)30093-4

journal_volume

105

pub_type

杂志文章

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