心肺康复杂志

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The Effect of Body Mass Index on Functional Outcome of Patients on Cardiac Rehabilitation

David T. Burke, MASamir Al-Adawi, Regina B. Bell, Daniel P. Burke

Background: While data suggests that obesity increases the risk for cardiovascular disease, some have demonstrated that after a cardiovascular event those with obesity tend to recover more quickly than do those whose weight is normal; a phenomenon termed the “obesity paradox”. This study was designed to determine whether this obesity paradox is also reflected in the recovery of patients with debility secondary to a cardiovascular event undergoing care in a rehabilitation hospital.
Objective: Investigate the association between body mass index (BMI) and the functional progress among patients with a recent cardiovascular decline, admitted to an acute rehabilitation hospital.
Design and methods: Retrospective cohort study which included all patients admitted to a rehabilitation hospital, with a recent diagnosis of acute cardiac decline from January 2000–April 2006. Main Outcome Measures: Functional Independence Measure (FIM) score gain per day by BMI category.
Results: Of the 678 patients admitted during the observation period, BMI was compared with FIM score changes per day (FIM efficiency). After adjusting for age, and sex, the FIM efficiency differed by BMI, though the difference was not statistically significant (p=0.069). While not statistically significant, the normal weight group showed the best results, followed, in order by the obese group, the overweight group, and the underweight group.
Conclusion: This study of patients on a cardiac rehabilitation unit failed to demonstrate that obesity significantly impairs functional progress during the rehabilitation process.