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

Journal Article

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 (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.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.

Full Text

Duke Authors

Cited 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,

Published Date

  • August 2016

Published In

Volume / Issue

  • 105 /

Start / End Page

  • 156 - 160

PubMed ID

  • 27290990

Electronic International Standard Serial Number (EISSN)

  • 1873-1570

International Standard Serial Number (ISSN)

  • 0300-9572

Digital Object Identifier (DOI)

  • 10.1016/j.resuscitation.2016.05.028

Language

  • eng