{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:58:11Z","timestamp":1790744291961,"version":"4.1.0"},"reference-count":18,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Being overweight or mildly obese has been associated with a decreased risk of death or hospitalization in patients with cardiovascular disease. Similarly, overweight patients admitted to an intensive care unit (ICU) have improved survival up to 1 year after admission. These counterintuitive observations are examples of the \u201cobesity paradox.\u201d Does the obesity paradox exist in patients with intracerebral hemorrhage (ICH)? In this study the authors examined whether there was an association between obesity and functional outcome in patients with ICH.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors analyzed 202 patients admitted to the neurological ICU (NICU) who were prospectively enrolled in the Columbia University ICH Outcomes Project between September 2009 and December 2012. Patients were categorized into 2 groups: overweight (body mass index [BMI] \u2265 25 kg\/m<jats:sup>2<\/jats:sup>) and not overweight (BMI &lt; 25 kg\/m<jats:sup>2<\/jats:sup>). The primary outcome was defined as survival with favorable outcome (modified Rankin Scale [mRS] score 0\u20133) versus death or severe disability (mRS score 4\u20136) at 3 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The mean age of the patients in the study was 61 years. The mean BMI was 28 \u00b1 6 kg\/m<jats:sup>2<\/jats:sup>. The mean Glasgow Coma Scale score was 10 \u00b1 4 and the mean ICH score was 1.9 \u00b1 1.3. The overall 90-day mortality rate was 41%. Among patients with a BMI &lt; 25 kg\/m<jats:sup>2<\/jats:sup>, 24% (17\/70) had a good outcome, compared with 39% (52\/132) among those with a BMI \u2265 25 kg\/m<jats:sup>2<\/jats:sup> (p = 0.03). After adjusting for ICH score, sex, do-not-resuscitate code status, and history of hypertension, being overweight or obese (BMI \u2265 25 kg\/m<jats:sup>2<\/jats:sup>) was associated with twice the odds of having a good outcome compared with patients with BMI &lt; 25 kg\/m<jats:sup>2<\/jats:sup> (adjusted odds ratio 2.05, 95% confidence interval 1.03\u20134.06, p = 0.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>In patients with ICH admitted to the NICU, being overweight or obese (BMI \u2265 25 kg\/m<jats:sup>2<\/jats:sup>) was associated with favorable outcome after adjustment for established predictors. The reason for this finding requires further study.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.5.jns163266","type":"journal-article","created":{"date-parts":[[2017,12,8]],"date-time":"2017-12-08T14:59:24Z","timestamp":1512745164000},"page":"1125-1129","source":"Crossref","is-referenced-by-count":27,"title":["Does the obesity paradox predict functional outcome in intracerebral hemorrhage?"],"prefix":"10.3171","volume":"129","author":[{"given":"Neha S.","family":"Dangayach","sequence":"first","affiliation":[{"name":"Departments of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai and Mount Sinai Health System, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harpreet Singh","family":"Grewal","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Foundation, Cleveland, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Marco","family":"De Marchis","sequence":"additional","affiliation":[{"name":"Department of Neurology & Stroke Center, University Hospital of Basel, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta K.","family":"Sefcik","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Bruce","sequence":"additional","affiliation":[{"name":"Department of Neurology, Division of Neurocritical Care, and Department of Neurosurgery, College of Physicians and Surgeons, Columbia University, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aarti","family":"Chhatlani","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, MetroHealth System, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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Cristina","family":"Falo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Division of Neurocritical Care, and Department of Neurosurgery, College of Physicians and Surgeons, Columbia University, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Neurology, Division of Neurocritical Care, and Department of Neurosurgery, College of Physicians and Surgeons, Columbia University, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Claassen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Division of Neurocritical Care, and Department of Neurosurgery, College of Physicians and Surgeons, Columbia University, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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