The Relationship between BMI and In-Hospital Outcomes in Patients with Acute Ischemic Stroke Undergoing Intravenous Thrombolysis: An Analysis Based on the China Stroke Center Alliance Registry Database

doi:10.3969/j.issn.1673-5765.2025.08.017

Abstract

Abstract: Objective To explore the relationship between BMI and in-hospital outcomes in hospitalized patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis.
Methods Based on the China Stroke Center Alliance (CSCA) registry database, AIS patients who received intravenous thrombolysis from August 2015 to December 2022 were included as the study subjects to analyze the trends in BMI and body weight. According to their BMI, the patients were divided into four groups: the underweight (BMI＜18.5 kg/m2) group, the normal weight (18.5 kg/m2≤BMI＜24 kg/m2) group, the overweight (24 kg/m2≤BMI＜28 kg/m2) group, and the obese (BMI≥28 kg/m2) group. The relationship between BMI and in-hospital outcomes (ischemic stroke recurrence and all-cause mortality) was analyzed.
Results A total of 154 503 hospitalized AIS patients who received intravenous thrombolysis were included in this study, with an average body weight of (65.23±12.46) kg and an average BMI of (23.67±4.27) kg/m2. Among them, 67 760 (43.86%) patients were classified as overweight or obesity. Multivariate logistic regression analysis showed that underweight was an independent risk factor for in-hospital death in AIS patients. Compared with normal weight patients, underweight patients had an increased risk of in-hospital death (adjusted OR 1.160, 95%CI 1.057-1.273, P=0.002). There was no statistically significant difference in in-hospital death rates among the overweight group, the obese group, and the normal weight group. Additionally, there was no statistically significant difference in in-hospital recurrence rates among different BMI groups.
Conclusions In this study, AIS patients receiving intravenous thrombolysis exhibited a high rate of overweight or obesity. Moreover, underweight was an independent risk factor for in-hospital death.

Key words: Acute ischemic stroke; Body weight; Body mass index; In-hospital outcome

摘要： 目的探讨接受静脉溶栓治疗的急性缺血性卒中（acute ischemic stroke，AIS）住院患者的BMI与其院内结局的关系。
方法基于中国卒中中心联盟（China Stroke Center Alliance，CSCA）登记数据库，纳入2015年8月—2022年12月接受静脉溶栓治疗的AIS患者作为研究对象，分析患者BMI及体重的变化趋势。根据患者的BMI，将其分为体重过低（BMI＜18.5 kg/m2）、体重正常（18.5 kg/m2≤BMI＜24 kg/m2）、超重（24 kg/m2≤BMI＜28 kg/m2）和肥胖（BMI≥28 kg/m2）4组，分析BMI与患者院内结局（缺血性卒中复发和全因死亡）的关系。
结果本研究共纳入154 503例接受静脉溶栓治疗的AIS住院患者，平均体重为（65.23±12.46）kg，平均BMI为（23.67±4.27）kg/m2，其中，超重和肥胖患者共67 760例（43.86%）。多因素logistic回归分析显示，体重过低是AIS患者院内死亡的独立危险因素，相较于体重正常患者，体重过低患者的院内死亡风险增高（校正OR 1.160，95%CI 1.057～1.273，P=0.002），超重组和肥胖组与体重正常组的院内死亡率差异无统计学意义。不同BMI组的院内复发率差异无统计学意义。
结论本研究中接受静脉溶栓治疗的AIS患者超重或肥胖率较高，体重过低是患者院内死亡的独立危险因素。

关键词: 急性缺血性卒中; 体重; 体重指数; 院内结局

CLC Number:

XIONG Yuting, CHENG Aichun, YIN Jinfeng, LI Zixiao, WANG Chunjuan, ZHANG Jing. The Relationship between BMI and In-Hospital Outcomes in Patients with Acute Ischemic Stroke Undergoing Intravenous Thrombolysis: An Analysis Based on the China Stroke Center Alliance Registry Database[J]. Chinese Journal of Stroke, 2025, 20(8): 1066-1072.

熊俞婷, 程爱春, 尹金风, 李子孝, 王春娟, 张静. BMI与急性缺血性卒中静脉溶栓患者院内结局的关系——基于中国卒中中心联盟登记数据库的分析[J]. 中国卒中杂志, 2025, 20(8): 1066-1072.

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