Obesity paradox in subarachnoid hemorrhage : a systematic review

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dc.contributor.author Rautalin, Ilari
dc.contributor.author Kaprio, Jaakko
dc.contributor.author Korja, Miikka
dc.date.accessioned 2021-01-04T14:40:01Z
dc.date.available 2021-01-04T14:40:01Z
dc.date.issued 2020-12
dc.identifier.citation Rautalin , I , Kaprio , J & Korja , M 2020 , ' Obesity paradox in subarachnoid hemorrhage : a systematic review ' , Neurosurgical Review , vol. 43 , no. 6 , pp. 1555-1563 . https://doi.org/10.1007/s10143-019-01182-5
dc.identifier.other PURE: 128115131
dc.identifier.other PURE UUID: 9ea51c0b-ad7f-4703-8786-406572298690
dc.identifier.other WOS: 000493337400001
dc.identifier.other ORCID: /0000-0002-4463-6954/work/86488094
dc.identifier.uri http://hdl.handle.net/10138/324009
dc.description.abstract As the number of obese people is globally increasing, reports about the putative protective effect of obesity in life-threatening diseases, such as subarachnoid hemorrhage (SAH), are gaining more interest. This theory-the obesity paradox-is challenging to study, and the impact of obesity has remained unclear in survival of several critical illnesses, including SAH. Thus, we performed a systematic review to clarify the relation of obesity and SAH mortality. Our study protocol included systematic literature search in PubMed, Scopus, and Cochrane library databases, whereas risk-of-bias estimation and quality of each selected study were evaluated by the Critical Appraisal Skills Program and Cochrane Collaboration guidelines. A directional power analysis was performed to estimate sufficient sample size for significant results. From 176 reviewed studies, six fulfilled our eligibility criteria for qualitative analysis. One study found paradoxical effect (odds ratio, OR = 0.83 (0.74-0.92)) between morbid obesity (body mass index (BMI) > 40) and in-hospital SAH mortality, and another study found the effect between continuously increasing BMI and both short-term (OR = 0.90 (0.82-0.99)) and long-term SAH mortalities (OR = 0.92 (0.85-0.98)). However, according to our quality assessment, methodological shortcomings expose all reviewed studies to a high-risk-of-bias. Even though two studies suggest that obesity may protect SAH patients from death in the acute phase, all reviewed studies suffered from methodological shortcomings that have been typical in the research field of obesity paradox. Therefore, no definite conclusions could be drawn. en
dc.format.extent 9
dc.language.iso eng
dc.relation.ispartof Neurosurgical Review
dc.rights cc_by
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Obesity
dc.subject Mortality
dc.subject Subarachnoid hemorrhage
dc.subject Systematic review
dc.subject BODY-MASS INDEX
dc.subject RISK-FACTORS
dc.subject VENOUS THROMBOEMBOLISM
dc.subject SUDDEN-DEATH
dc.subject MORTALITY
dc.subject STROKE
dc.subject OVERWEIGHT
dc.subject SURVIVORS
dc.subject OUTCOMES
dc.subject IMPACT
dc.subject 3112 Neurosciences
dc.subject 3124 Neurology and psychiatry
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology
dc.title Obesity paradox in subarachnoid hemorrhage : a systematic review en
dc.type Review Article
dc.contributor.organization Neurokirurgian yksikkö
dc.contributor.organization HUS Neurocenter
dc.contributor.organization University of Helsinki
dc.contributor.organization Helsinki University Hospital Area
dc.contributor.organization Department of Public Health
dc.contributor.organization Institute for Molecular Medicine Finland
dc.contributor.organization Genetic Epidemiology
dc.contributor.organization Clinicum
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1007/s10143-019-01182-5
dc.relation.issn 0344-5607
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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