Abstract Number ‐ 166: Effect Of Obesity on Outcomes of Mechanical Thrombectomy
Authors: Rodriguez Wilson E , Gordon Weston , Fedorova Margarita , Miremadi Brian , Scott Jordan , Khasiyev Farid , Kiaei Benjamin , LinaresChristopher Guillermokara 
Published: April 2023

Introduction

Obesity is a chronic disease that continues to increase in prevalence across the globe. In population studies, obesity has been shown to increase the risk for ischemic strokes. However, the obesity paradox has been observed in several studies showing better post‐stroke outcomes in patients with obesity than in those with normal weight.The influence of BMI in ischemic strokes treated with mechanical thrombectomy (MT) remains unclear. We aimed to assess if obesityis associated with poor functional outcomes defined as a modified Rankin Scale (mRS) score of 3–6 in patients following mechanical thrombectomy.

Methods

We reviewed 178 patients with large vessel occlusion (LVO) who underwent MT between 2019 and 2022. Obesity was defined as BMI ≥ 30.0 kg/m2.The primary outcome was mRS at 90 days. Secondary endpoints were time from puncture to reperfusion, number of passes before revascularization, the ratesof successful reperfusion using thethrombolysis in cerebral infarction(TICI)scale (mTICI≥ 2b), and mortality rate.Univariate analysis for primary and secondary endpoints was conducted using chi‐square for categorical variables and independent samples t‐tests for continuous variables. Multivariate logistic regression was used to examine the role of obesity and potential covariates on 90‐day mRS. All analyses were conducted using IBM SPSS Statistics version 27.

Results

Of the studied patients, 45% had obesity. Those with obesity were younger (mean age = 61.42 vs 68.25 years in those without obesity, t = 3.21, p< 0.001)), and had higher baseline glucose levels (156.3 mg/dL vs. 136.4 mg/dL, t = ‐2.06, p = 0.02). There were no significant differences in baseline NIHSS score, ASPECTS, history of congestive heart failure, hypertension, IV tPA administration, use of general anesthesia, or occlusion site. Here, obesity was not a predictor of 90‐ day mRS (aOR = 0.49, 95%CI = 0.20‐1.20). There were no significant differences in 90‐day mRS for any additional variables included in the model.For secondary endpoints, there were no significant differences in timing from puncture time to time of reperfusion (p = 0.40), number of passes before revascularization (p = 0.47), the rate of successful reperfusion (p = 0.65), and NIH score at discharge (p = 0.46). While not a focus of the current study, it is interesting to note that, compared to those with obesity, overweight patients had higher odds of mortality during the study period (cOR = 2.83, 95%CI = 1.35‐5.93). However, this relationship was only present on univariate analysis.

Conclusions

Obesity is highly prevalent in patients undergoing mechanical thrombectomy. In this study, we found that body mass index is not a predictor of functional outcomes in patients who undergo mechanical thrombectomy. There is no difference in intraprocedural times or likelihood of successful recanalization. Body mass index does not change the likelihood of discharge to an acute rehabilitation facility.