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

American Heart Association's Get With The Guidelines®-Resuscitation Investigators

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 <18.5 kg/m2), normal weight (BMI 18.5-24.9 kg/m2), over-weight (BMI 25.0-29.9 kg/m2), obese (BMI 30.0-34.9 kg/m2), and extremely obese (BMI ≥ 35.0 kg/m2). 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 24 h, 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.

Original languageEnglish (US)
Pages (from-to)156-160
Number of pages5
JournalResuscitation
Volume105
DOIs
StatePublished - Aug 1 2016

Fingerprint

Ventricular Fibrillation
Ventricular Tachycardia
Body Mass Index
Shock
Survival
Thinness
Weights and Measures
Impedance Cardiography
Resuscitation
Cluster Analysis
Registries
Linear Models
Odds Ratio
Guidelines
Confidence Intervals

Keywords

  • Cardiac arrest
  • First shock success
  • Index event
  • Obesity
  • Resuscitation
  • Shockable rhythm

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine

Cite this

Body mass index and outcomes of in-hospital ventricular tachycardia and ventricular fibrillation arrest. / American Heart Association's Get With The Guidelines®-Resuscitation Investigators.

In: Resuscitation, Vol. 105, 01.08.2016, p. 156-160.

Research output: Contribution to journalArticle

American Heart Association's Get With The Guidelines®-Resuscitation Investigators 2016, 'Body mass index and outcomes of in-hospital ventricular tachycardia and ventricular fibrillation arrest', Resuscitation, vol. 105, pp. 156-160. https://doi.org/10.1016/j.resuscitation.2016.05.028
American Heart Association's Get With The Guidelines®-Resuscitation Investigators. Body mass index and outcomes of in-hospital ventricular tachycardia and ventricular fibrillation arrest. Resuscitation. 2016 Aug 1;105:156-160. https://doi.org/10.1016/j.resuscitation.2016.05.028
American Heart Association's Get With The Guidelines®-Resuscitation Investigators. / Body mass index and outcomes of in-hospital ventricular tachycardia and ventricular fibrillation arrest. In: Resuscitation. 2016 ; Vol. 105. pp. 156-160.
@article{b0540c7c76fa405bb2b0cbe7cf98a874,
title = "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{\circledR}-Resuscitation (GWTG-R) Multicenter Observational Registry between 2006 and 2012. Patients were categorized as underweight (BMI <18.5 kg/m2), normal weight (BMI 18.5-24.9 kg/m2), over-weight (BMI 25.0-29.9 kg/m2), obese (BMI 30.0-34.9 kg/m2), and extremely obese (BMI ≥ 35.0 kg/m2). 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 24 h, 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.",
keywords = "Cardiac arrest, First shock success, Index event, Obesity, Resuscitation, Shockable rhythm",
author = "{American Heart Association's Get With The Guidelines{\circledR}-Resuscitation Investigators} and Ogunnaike, {Babatunde O.} and Whitten, {Charles W.} and Abu Minhajuddin and Emily Melikman and Joshi, {Girish P.} and Moon, {Tiffany S.} and Schneider, {Preston M.} and Bradley, {Steven M.} and Saket Girotra and Chan, {Paul S.} and Anderson, {Monique L.} and Churpek, {Matthew M.} and Edelson, {Dana P.} and Donnino, {Michael W.} and Faillace, {Robert T.} and Romergryko Geocadin and Idris, {Ahamed H.} and Merchant, {Raina M.} and Mosesso, {Vincent N.} and Ornato, {Joseph P.} and Peberdy, {Mary Ann} and Perman, {Sarah M.} and Mindy Smyth",
year = "2016",
month = "8",
day = "1",
doi = "10.1016/j.resuscitation.2016.05.028",
language = "English (US)",
volume = "105",
pages = "156--160",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Body mass index and outcomes of in-hospital ventricular tachycardia and ventricular fibrillation arrest

AU - American Heart Association's Get With The Guidelines®-Resuscitation Investigators

AU - Ogunnaike, Babatunde O.

AU - Whitten, Charles W.

AU - Minhajuddin, Abu

AU - Melikman, Emily

AU - Joshi, Girish P.

AU - Moon, Tiffany S.

AU - Schneider, Preston M.

AU - Bradley, Steven M.

AU - Girotra, Saket

AU - Chan, Paul S.

AU - Anderson, Monique L.

AU - Churpek, Matthew M.

AU - Edelson, Dana P.

AU - Donnino, Michael W.

AU - Faillace, Robert T.

AU - Geocadin, Romergryko

AU - Idris, Ahamed H.

AU - Merchant, Raina M.

AU - Mosesso, Vincent N.

AU - Ornato, Joseph P.

AU - Peberdy, Mary Ann

AU - Perman, Sarah M.

AU - Smyth, Mindy

PY - 2016/8/1

Y1 - 2016/8/1

N2 - 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 <18.5 kg/m2), normal weight (BMI 18.5-24.9 kg/m2), over-weight (BMI 25.0-29.9 kg/m2), obese (BMI 30.0-34.9 kg/m2), and extremely obese (BMI ≥ 35.0 kg/m2). 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 24 h, 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.

AB - 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 <18.5 kg/m2), normal weight (BMI 18.5-24.9 kg/m2), over-weight (BMI 25.0-29.9 kg/m2), obese (BMI 30.0-34.9 kg/m2), and extremely obese (BMI ≥ 35.0 kg/m2). 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 24 h, 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.

KW - Cardiac arrest

KW - First shock success

KW - Index event

KW - Obesity

KW - Resuscitation

KW - Shockable rhythm

UR - http://www.scopus.com/inward/record.url?scp=84974785435&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84974785435&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2016.05.028

DO - 10.1016/j.resuscitation.2016.05.028

M3 - Article

C2 - 27290990

AN - SCOPUS:84974785435

VL - 105

SP - 156

EP - 160

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -