Impact of obesity on poor prognosis of intravenous thrombolysis in patients with first-episode acute ischemic stroke

Jiang Rui; Feng Jie; Shan Qingting; Wang Wei; Zhai Guojie

doi:10.3969/j.issn.1009-6574.2024.08.003

Abstract：Objective To explore the impact of obesity on poor prognosis of recombinant tissue plasminogen activator(rt-PA)intravenous thrombolysis in patients with first-episode acute ischemic stroke.Methods From December 2017 to December 2023,297 patients with first-episode stroke who underwent rt-PA intravenous thrombolysis in the Department of Neurology of Suzhou Ninth Hospital affiliated to Soochow University were selected as participants.According to the 90 days Modified Rankin Scale(mRS)score,patients were divided into a poor prognosis group(mRS score of 3 to 6)and a good prognosis group(mRS score of 0 to 2).Multivariate Logistic regression was used to analyze the risk factors for poor 90-day prognosis in patients with acute ischemic stroke undergoing intravenous thrombolysis.Results Among 297 patients with first-episode acute ischemic stroke,212 had good prognosis and 85 had poor prognosis,with a poor prognosis rate of 28.62%.In the poor prognosis group,obese patients(BMI≥28.0 kg/m2)accounted for 27.06%(23/85),smoking patients accounted for 31.76%(27/85),and the National Institute of Health Stroke Scale(NIHSS)score before thrombolysis was 13.00(9.50,18.00),which were higher than the good prognosis group's 16.98%(36/212),20.28%(43/212),and 7.00(5.00,11.00),respectively,and the differences were statistically significant(χ2/Z=3.871,4.440,-8.013;P＜0.05).Multivariate Logistic regression analysis showed that obesity(OR=2.918,95%CI=1.364-6.242),smoking(OR=3.648,95%CI=1.678-7.931),and high pre-thrombolysis NIHSS score(OR=1.269,95%CI=1.184-1.361)were risk factors for poor prognosis in patients with acute ischemic stroke undergoing intravenous thrombolysis,with statistically significant differences(P＜0.05).Conclusions Obesity is a risk factor for poor prognosis after 90 days of intravenous thrombolysis in patients with first-episode ischemic stroke.