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Background <p>Studies have revealed a paradoxical "protective effect" of increased body mass index (BMI) on functional recovery and survival in stroke patients. However, the relationship between poststroke BMI and mortality risk among stroke survivors remains poorly understood. This study utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999–2018 to examine the association of poststroke BMI with all-cause and cause-specific mortality among stroke survivors.</p> Methods <p>A retrospective cohort was designed based on NHANES 1999–2018. Weighted Cox proportional hazards regression models was performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).</p> Results <p>A total of 1901 stroke survivors aged 20–85 were included for final analysis. After a median follow-up period of 77&#xa0;month from the time of interview, 847 deaths were identified. Compared to the normal-weight population, we observed an inverse association between all-cause mortality and overweight and obesity. Restricted cubic spline plots show a non-linear trend between BMI and mortality (<i>P</i> for non-linearity = 0.002). Stratification analysis by sex demonstrated overweight and obesity were significantly associated with a decreased risk of mortality in females, but not in males. Further interaction analyses showed no significance between women and men (P for interaction = 0.650).</p> Conclusions <p>In summary, our study supports the existence of an obesity paradox among female stroke survivors.</p>

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Post-Stroke Body Mass Index and Mortality in Stroke Survivors

  • 期刊论文

  • 发表日期：

    2025年9月2日

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  • Chuan Shao,
  • Dewei Zou,
  • Chao Xu,
  • Gang Zhang,
  • Haotian Jiang,
  • Cheng Zeng,
  • Tao Tang,
  • Hui Tang,
  • Nan Wu

摘要

Background

Studies have revealed a paradoxical "protective effect" of increased body mass index (BMI) on functional recovery and survival in stroke patients. However, the relationship between poststroke BMI and mortality risk among stroke survivors remains poorly understood. This study utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999–2018 to examine the association of poststroke BMI with all-cause and cause-specific mortality among stroke survivors.

Methods

A retrospective cohort was designed based on NHANES 1999–2018. Weighted Cox proportional hazards regression models was performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

A total of 1901 stroke survivors aged 20–85 were included for final analysis. After a median follow-up period of 77 month from the time of interview, 847 deaths were identified. Compared to the normal-weight population, we observed an inverse association between all-cause mortality and overweight and obesity. Restricted cubic spline plots show a non-linear trend between BMI and mortality (P for non-linearity = 0.002). Stratification analysis by sex demonstrated overweight and obesity were significantly associated with a decreased risk of mortality in females, but not in males. Further interaction analyses showed no significance between women and men (P for interaction = 0.650).

Conclusions

In summary, our study supports the existence of an obesity paradox among female stroke survivors.