Obesity and post-discharge outcomes in hospitalized patients with heart failure: a real-world cohort study
E Chuquiure-Valenzuela, M Tapia-Sansores, A Mendoza-Cortez, G Martinez-Gonzalez, F Bejarano-Vergara, R Garduno-Correa, E Silva-Mauricio, F Gonzalez-Mayo, K Bautista-Hernandez, A Perez-Falcon, R Lozano-Corral, V Flores-GutierrezAbstract
Background
To evaluate 30-day and 1-year mortality after hospital discharge, as well as the incidence of emergency department visits, in hospitalized patients with heart failure and obesity.
Material and Method
A retrospective clinical cohort of adult patients hospitalized for cardiovascular disease was conducted. Patients were stratified according to body mass index (BMI) into two groups: BMI ≥30 kg/m² (obesity) and BMI <29.99 kg/m². Baseline clinical characteristics, mortality, and emergency department visits at 30 days and 1 year after hospital discharge were compared. Statistical analyses included chi-square and Student’s t tests, with significance defined as p<0.05.
Results
A total of 923 patients with complete follow-up were included. Patients with obesity showed a higher prevalence of type 2 diabetes mellitus, systemic arterial hypertension, metabolic syndrome, and smoking (all p<0.01). No deaths occurred within 30 days in the obesity group, compared with a 1.68% mortality rate in the non-obesity group (χ²=2.35, p=0.125). At 1 year, mortality was significantly lower among patients with obesity (1.44% vs 5.03%; χ²=4.29, p=0.038). No significant differences were observed in emergency department visits at 30 days (χ²=0.26, p=0.610) or at 1 year (χ²=0.20, p=0.655).
Conclusion
Obesity was not associated with increased early mortality or higher rates of emergency department visits. Conversely, a lower 1-year mortality was observed, supporting the presence of the so-called obesity paradox in hospitalized patients with heart failure.Post discharge outcomes by BMI groupsFor image description, please refer to the figure legend and surrounding text.