Profiling of acute dyspnea patients according to body mass index and systolic blood pressure predicts mortality

Objective: To evaluate whether profiling of acute dyspnea patients according to body mass index (BMI) and systolic blood pressure (SBP) at admission helps to predict their risk of death after 6 months.

Design and method: Prospective multicentre observational cohort study enrolled dyspnoeic patients admitted to the ED with acute heart failure, exacerbation of chronic obstructive pulmonary disease, pneumonia, pulmonary embolism and other conditions from March, 2015 until December, 2017. Data of 1440 dyspnoeic patients were collected. Current study included 793 (55.1%) patients with available BMI and SBP. Patients were distributed into 4 profiles: I – BMI >30 kg/m2 and SBP > = 140 mmHg; II – BMI = < 30 kg/m2 and SBP > = 140 mmHg; III – BMI >30 kg/m2 and SBP < 140 mmHg; IV – BMI = <30 kg/m2 and SBP < 140 mmHg. Chi-square test, Kaplan-Meier curves and Cox proportional hazard model were used to analyse survival differences in the four profiles. Multivariate analysis was adjusted to age, gender, history of chronic heart failure, coronary artery disease, diabetes mellitus, anemia and eGFR < 60 ml/min/1.73m2. Data were analysed using R statistical software.

Results: In 793 patients of current analysis 59% were men, mean age was 69 ± 13, mean BMI was 30.7 ± 7.4 kg/m2 and mean SBP was 140 ± 27 mmHg, 61.7% were diagnosed with acute heart failure. At admission, profile I consisted of 202 (25.5%) patients, II of 190 (24.0%) patients, III of 166 (20.9%) patients, IV of 235 (29.6%) patients. Mortality rates after 6 months were: 14 patients (6.9%) of I profile; 23 patients (12.1%) of II profile; 28 patients (16.9%) of III profile; 48 patients (20.4%) of IV profile (p < 0.01). When using the I group as a reference, the III and IV profiles had higher risk of 1-year mortality in both univariate and multivariate Cox regression analysis (Table 1), while the II profile did not.

E-POSTER'S SESSION: COMPLICATIONS AND COMORBIDITIES: PDF ONLY PROFILING OF ACUTE DYSPNEA PATIENTS ACCORDING TO BODY MASS INDEX AND SYSTOLIC BLOOD PRESSURE PREDICTS MORTALITY Verikas, D.1; Cerlinskaite, K.2; Rimkus, A.2; Vaiciuliene, D.1; Mebazaa, A.3; Kavoliuniene, A.1; Celutkiene, J.4 Author Information Journal of Hypertension 37():p e310, July 2019. | DOI: 10.1097/01.hjh.0000573888.55635.b2

Metrics Abstract Objective: To evaluate whether profiling of acute dyspnea patients according to body mass index (BMI) and systolic blood pressure (SBP) at admission helps to predict their risk of death after 6 months.

Design and method: Prospective multicentre observational cohort study enrolled dyspnoeic patients admitted to the ED with acute heart failure, exacerbation of chronic obstructive pulmonary disease, pneumonia, pulmonary embolism and other conditions from March, 2015 until December, 2017. Data of 1440 dyspnoeic patients were collected. Current study included 793 (55.1%) patients with available BMI and SBP. Patients were distributed into 4 profiles: I – BMI >30 kg/m2 and SBP > = 140 mmHg; II – BMI = < 30 kg/m2 and SBP > = 140 mmHg; III – BMI >30 kg/m2 and SBP < 140 mmHg; IV – BMI = <30 kg/m2 and SBP < 140 mmHg. Chi-square test, Kaplan-Meier curves and Cox proportional hazard model were used to analyse survival differences in the four profiles. Multivariate analysis was adjusted to age, gender, history of chronic heart failure, coronary artery disease, diabetes mellitus, anemia and eGFR < 60 ml/min/1.73m2. Data were analysed using R statistical software.

Results: In 793 patients of current analysis 59% were men, mean age was 69 ± 13, mean BMI was 30.7 ± 7.4 kg/m2 and mean SBP was 140 ± 27 mmHg, 61.7% were diagnosed with acute heart failure. At admission, profile I consisted of 202 (25.5%) patients, II of 190 (24.0%) patients, III of 166 (20.9%) patients, IV of 235 (29.6%) patients. Mortality rates after 6 months were: 14 patients (6.9%) of I profile; 23 patients (12.1%) of II profile; 28 patients (16.9%) of III profile; 48 patients (20.4%) of IV profile (p < 0.01). When using the I group as a reference, the III and IV profiles had higher risk of 1-year mortality in both univariate and multivariate Cox regression analysis (Table 1), while the II profile did not.

Image Conclusions: Profiling acute dyspnoea patients according to body mass index and systolic blood pressure reveals a different 6 months mortality risk. Non-obese non-hypertensive profile (likely marker of advanced disease) showed 3-fold higher risk of death compared to obese hypertensive patients.