Relationship between Body Mass Index and in-hospital Outcomes of Acute Myocardial Infarction Patients at a Selected Critical Care Unit of a University Hospital - Egypt.

Abstract

Myocardial infarction (MI) is acute and catastrophic event. It is one of the leading causes to morbidity and mortality worldwide. Multiple risk factors were found to be responsible for the occurrence of MI; among these factors are overweight and obesity. Therefore, the aim of the present study is to study the relationship between body mass index (BMI) and in-hospital outcomes among acute myocardial infarction patients at a selected critical care unit of a university hospital. Two research questions were formulated:1- What is the body mass index profile of acute myocardial infarction patients admitted to a selected critical care unit of a university hospital?; and 2: What is the relationship between body mass index and different in-hospital outcomes of acute myocardial infarction patients admitted to a selected critical care unit of a university hospital?. A descriptive exploratory research design was utilized. The current study was conducted at a selected critical care unit of a university hospital, in Egypt. A sample of convenience including 60 adult male and female patients was included in the current study. Two tools were developed by the researcher and utilized to collect data pertinent to the current study: Socio-demographic and medical data sheet which covers data about patients’ age, gender, diagnosis, body weight, height, length of ICU stay, past medical history, current or recent smoking, and at home medications; and Patient’s assessment sheet which was developed based on Acute Coronary Treatment and Intervention Outcomes Network (ACTION) Registry-Get with the Guidelines (GWTG). It covers data such as: patients’ presentation; laboratory findings; reperfusion strategy; medications within 24 hours of admission and at discharge; discharge intervention and in- hospital outcomes. Results: males represented the great majority (90%) of the studied sample. They had different BMI categories: overweight, grade I, and grade II obesity, in percentages of 33.3%, 30%, and 25% respectively, with a mean BMI of 31.52+ 4.96. No significant statistical relationship was found between BMI and gender. The studied group admitted as a result of acute anterior MI, acute inferior MI, and acute unspecific MI, in percentages of 45%, 30%& 25% respectively. No significant statistical relationship was found between BMI and diagnosis. Around two thirds of the studied group (58.2%) experienced different in hospital problems/outcomes: recurrent MI attacks (26.7%), cardiogenic shock (18.3%), C.V.S (6.6%), and Death (6.6%). High significant statistical relationship was found between BMI and in-hospital outcomes (Chi square = 46.13 at p<0.004). Based on findings of the present study it can be concluded that the majority of acute myocardial infarction patients had above normal BMI values ranging from over weight to the third grade obesity (in the current study), and obviously was significantly related to the adverse in hospital outcomes. Therefore, the current study recommends, the important role of the critical care nurse in monitoring myocardial infarction patients’ nutritional status through assessing their body mass index, thus providing individualized in hospital / at discharge instructions, which could enhance patients’ outcomes, and reduce complications.

Key words: Acute Myocardial Infarction, Body Mass Index, Risk factors, In- hospital patients’ outcomes.