Burden and impact of metabolically healthy obesity on in-hospital outcomes of acute ischemic stroke: A nationwide study

Table 1 Baseline characteristics, comorbidities, substance use variables, and outcomes following acute ischemic stroke in patients with and without metabolically healthy obesity, 2020

Variables		Non-MHO (n = 4935)	MHO (n = 4935)	P value
Demographic characteristics
Age (years) at admission	Median [IQR]	61 [54-66]	56 [50-62]	0.115
	18-44	29.9	29.0
	45-64	36.5	38.6
	≥ 65	33.5	32.4
Sex	Male	37.4	38.8	0.146
	Female	62.6	61.2
Race	Whites	67.2	69.3	0.083
	Blacks	19.2	18.6
	Hispanics	11.3	10.3
	Asian/PI	1.4	1.2
	Nat Ame	0.9	0.6
Socioeconomic & hospital characteristics
Median household income national quartile for patient ZIP code	0-25th	32.0	32.3	< 0.0001
	26-50th	25.9	29.8
	51-75th	23.0	23.3
	76-100th	19.1	14.6
Payer type	Medicaid	40.3	35.6	< 0.0001
	Private	59.7	64.4
Hospital location & teaching status	Rural	7.0	5.8	< 0.0001
	Urban non-teaching	12.5	15.2
	Urban teaching	80.5	79.0
Hospital region	Northeast	20.1	16.2	< 0.0001
	Midwest	17.9	21.9
	South	42.6	42.1
	West	19.4	19.7
Clinical comorbidities
Peripheral vascular disease		10.6	9.7	0.182
Prior myocardial infarction		2.3	1.7	0.032
Prior TIA/stroke without neurologic deficit		7.8	6.7	0.033
Prior venous thromboembolism		5.2	4.9	0.489
Valvular disease		2.4	1.0	< 0.0001
Cancer		11.2	7.3	< 0.001
Chronic kidney disease		4.9	5.2	0.489
Acquired immune deficiency syndrome		1.2	0.2	< 0.0001
Depression		9.8	10.6	< 0.244
Chronic pulmonary disease		14.2	16.6	< 0.001
Hypothyroidism		6.9	9.9	0.0001
Other thyroid disorders		1.9	1.6	0.253
Substance use variables
Alcohol abuse		7.2	4.7	< 0.0001
Drug abuse		10.1	5.6	< 0.0001
Cocaine		2.5	1.7	< 0.0005
Tobacco use disorder		17.8	16.8	0.182
Outcomes
All-cause mortality		14.5	13.5	0.613
Disposition of patient	Routine	44.8	43.3	0.021
	Transfer to short-term Hospital	4.2	4.3
	Transfer other: SNF, ICF, etc.	35.9	38.8
	Home health care	15.2	13.6
Length of stay in days	Median [IQR]	5 [2-13]	5 [2-12]	0.032
Health care expenses (in United States dollars)	Median	$78270	$88297	0.001

P < 0.05 was considered statistically significant. PI: Pacific Islanders; Nat Ame: Native Americans; TIA: Transient ischemic attack; IQR: Interquartile range; SNF: Skilled nursing facility; ICF: Intermediate care facility; MHO: Metabolically healthy obesity.

Table 2 Multivariable logistic regression assessing the odds of in-hospital mortality following acute ischemic stroke in patients with and without metabolically healthy obesity

In-hospital mortality	Metabolically healthy obesity	Adjusted OR	95%CI		P value
			Lower Limit	Upper limit
Overall mortality	Yes vs no	0.93	0.70	1.24	0.613
In-hospital mortality by individual subgroup
18-44 years	Yes vs no	0.85	0.42	1.73	0.662
45-64 years	Yes vs no	0.98	0.60	1.61	0.930
≥ 65 years	Yes vs no	1.02	0.65	1.61	0.930
Male	Yes vs no	1.04	0.64	1.70	0.880
Female	Yes vs no	0.96	0.65	1.39	0.812
Whites	Yes vs no	0.92	0.66	1.28	0.618
Blacks	Yes vs no	0.77	0.33	1.80	0.546
Hispanics	Yes vs no	1.01	0.34	3.01	0.981
Asian/Pacific Islanders	Yes vs no	2.93	0.46	18.82	0.256

P < 0.05 indicates statistical significance. Multivariable regression models were adjusted for baseline demographics, hospital level characteristics and peripheral vascular disease, tobacco use disorder, prior myocardial infarction, prior transient ischemic attack, prior sudden cardiac arrest, prior venous thromboembolism, cancer, chronic kidney disease, acquired immune deficiency syndrome, alcohol abuse, drug abuse, cocaine, cannabis, depression, chronic pulmonary disease, hypothyroidism, other thyroid disorders, valvular disease, autoimmune conditions, coronavirus disease 2019. CI: Confidence interval; OR: Odds ratio.