Do Body Mass Index and Nutritional Risk Score 2002 Influence the In-Hospital Mortality of Patients Following Cardiac Arrest?

Piotr Fehler; Marzena Zielińska; Bartosz Uchmanowicz; Raúl Juárez-Vela; Łukasz Lewandowski; Stanisław Zieliński; Michał Czapla

doi:10.3390/nu15020436

Do Body Mass Index and Nutritional Risk Score 2002 Influence the In-Hospital Mortality of Patients Following Cardiac Arrest?

Nutrients. 2023 Jan 14;15(2):436. doi: 10.3390/nu15020436.

Authors

Piotr Fehler^{1

2}, Marzena Zielińska^{2

3}, Bartosz Uchmanowicz⁴, Raúl Juárez-Vela⁵, Łukasz Lewandowski⁶, Stanisław Zieliński^{2

3}, Michał Czapla^{1

5

7}

Affiliations

¹ Institute of Heart Diseases, University Hospital, 50-566 Wrocław, Poland.
² Department of Anaesthesiology and Intensive Care, University Hospital, 50-556 Wrocław, Poland.
³ Department and Clinic of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Wrocław Medical University, 50-556 Wrocław, Poland.
⁴ Department of Nursing and Obstetrics, Faculty of Health Sciences, Wrocław Medical University, 51-618 Wrocław, Poland.
⁵ Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain.
⁶ Department of Medical Biochemistry, Wrocław Medical University, 50-368 Wrocław, Poland.
⁷ Department of Emergency Medical Service, Wrocław Medical University, 51-616 Wrocław, Poland.

Abstract

Background: Contemporarily, cardiac arrest (CA) remains one of the leading causes of death. Poor nutritional status can increase the post-CA mortality risk. The aim of this study was to determine the relationship between body mass index (BMI) and Nutritional Risk Score 2002 (NRS 2002) results and in-hospital mortality in patients admitted to the intensive care unit (ICU) after in-hospital and out-of-hospital cardiac arrest.

Methods: A retrospective study and analysis of medical records of 161 patients admitted to the ICU of the University Clinical Hospital in Wrocław (Wrocław, Poland) was conducted.

Results: No significant differences in body mass index (BMI) and nutritional risk score (NRS 2002) values were observed between non-survivors and survivors. Non-survivors had significantly lower albumin concentration (p = 0.017) and total cholesterol (TC) (p = 0.015). In multivariate analysis BMI and NRS 2002 scores were not, per se, associated with the in-hospital mortality defined as the odds of death (Model 1: p: 0.700, 0.430; Model 2: p: 0.576, 0.599). Univariate analysis revealed significant associations between the hazard ratio (HR) and TG (p ≈ 0.017, HR: 0.23) and hsCRP (p ≈ 0.018, HR: 0.34). In multivariate analysis, mortality risk over time was influenced by higher scores in parameters such as BMI (HR = 0.164; p = 0.048) and hsCRP (HR = 1.006, p = 0.002).

Conclusions: BMI and NRS 2002, on their own (unconditionally - in the whole study group) did not alter the odds of mortality in patients admitted to the intensive care unit (ICU) after in-hospital and out-of-hospital cardiac arrest. The risk of in-hospital mortality (expressed as hazard ratio - the risk over the time period of the study) increased with an increase in BMI but not with NRS 2002.

Keywords: BMI; ICU; ROSC; mortality; obesity; sudden cardiac arrest.

MeSH terms

Body Mass Index
C-Reactive Protein
Hospital Mortality
Humans
Out-of-Hospital Cardiac Arrest*
Retrospective Studies
Risk Factors

Substances

C-Reactive Protein

Grants and funding

This research was funded by the Ministry of Science and Higher Education of Poland under the statutory grant of the Wrocław Medical University (SUBZ.E250.22.095).