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Table 4 Included studies reporting mortality risk from CV events/total knee arthroplasty/stroke in populations with obesity or OWRC

From: Understanding the risk of developing weight-related complications associated with different body mass index categories: a systematic review

Study

Year

Country

Comorbidity

BMI (kg/m2)

Risk

Mortality

Note

Batsis et al. [69]

2014

USA

Not reported

≥ 30.0

HR 0.90 (95% CI 0.57–1.43)

CV

Relative to normal weight (BMI 18.5–25.0)

Crotti et al. [71]

2018

Italy

Not reported

30.0–39.9

HR 1.01 (95% CI 0.75–1.35)

CV

Relative to normal weight (BMI 18.5–24.9)

≥ 40

HR 1.32 (95% CI 0.53–3.28)

Perotto et al. [70]

2013

Italy

T2D

26.8–30.0 (< 65 years old)

HR 1.29 (95% CI 0.62–2.65)

CV

Relative to BMI < 24.2

> 30.0 (< 65 years old)

HR 0.83 (95% CI 0.39–1.74)

26.8–30.0 (≥ 65 years old)

HR 0.86 (95% CI 0.64–1.19)

> 30.0 (≥ 65 years old)

HR 0.67 (95% CI 0.45–0.95)

Ratwatte et al. [72]

2021

Australia

Not reported

30.0–39.9

OR 0.42 (95% CI 0.25–0.72)

CV (in-hospital mortality for acute coronary syndrome)

Relative to normal weight (BMI 18.5–24.9)

> 40.0

OR 0.97 (95% CI 0.45–2.1)

30.0–39.9

OR 0.37 (95% CI 0.15–0.91)

CV (6 months post hospitalization for acute coronary syndrome)

> 40.0

OR 0.88 (95% CI 0.22–3.54)

Bhaskaran et al. [73]

2018

UK

Not reported

30.0–34.9

HR 1.27 (95% CI 1.25–1.30)

CV

Relative to BMI 22.5–24.9

35.0–39.9

HR 1.65 (95% CI 1.60–1.70)

≥ 40.0

HR 2.49 (95% CI 2.37–2.61)

Boggs et al. [74]

2011

USA

Not reported

30.0–34.9

HR 2.77 (95% CI 1.62–4.73)

CV

Relative to BMI 20.0–24.9

35.0–49.9

HR 3.90 (95% CI 2.29–6.64)

Borgeraas et al. [53]

2014

Norway

Not reported

≥ 30.0 (male)

HR 1.19 (95% CI 0.76–1.85)

CV

Relative to normal weight (BMI 18.5–24.9)

≥ 30.0 (female)

HR 0.43 (95% CI 0.14–1.28)

Champagne-Langabeer et al. [75]

2017

USA

Not reported

30.0–34.9

OR 1.20 (95% CI 0.46–3.11)

CV

Relative to normal weight (BMI 18.5–24.9)

35.0–39.9

OR 0.65 (95% CI 0.14–3.06)

≥ 40.0

OR 3.83 (95% CI 1.02–14.41)

Czernichow et al. [78]

2011

UK

Not reported

20.0–35.0

HR 1.10 (95% CI 1.05–1.16)

CV

HR for one higher standard deviation in BMI

Das et al. [79]

2011

USA

Not reported

35.0–<40.0

HR 1.10 (95% CI 0.95–1.26)

CV

Relative to BMI 30.0 to <35.0

≥ 40.0

HR 1.64 (95% CI 1.32–2.03)

Eeg-Olofsson et al. [80]

2014

Sweden

T2D

25.0–27.4

HR 0.79 (95% CI 0.65–0.96)

CV

Relative to normal weight (BMI 18.5–24.9)

27.5–29.9

HR 0.92 (95% CI 0.76–1.11)

30.0–34.9

HR 1.16 (95% CI 0.97–1.38)

≥ 35.0

HR 1.55 (95% CI 1.26–1.90)

Hotchkiss et al. [85]

2013

UK

Not reported

≥ 30.0 (male)

HR 1.13 (95% CI 0.69–1.86)

CV

Relative to normal weight (BMI 18.5–25.0)

≥ 30.0 (female)

HR 1.51 (95% CI 0.90–2.56)

Kjøllesdal et al. [86]

2019

Norway

Not reported

≥ 30.0

HR 1.66 (95% CI 1.53–1.74)

CV

Relative to BMI < 25.0

Kjøllesdal et al. [87]

2018

Norway

Not reported

≥ 30.0 (male, early adulthood)

HR 2.70 (95% CI 1.88–3.78)

CV

Relative to normal weight (BMI 18.5–25.0)

≥ 30.0 (male, midlife)

HR 1.46 (95% CI 1.25–1.70)

≥ 30.0 (female, early adulthood)

HR 1.81 (95% CI 0.82–3.97)

≥ 30.0 (female, midlife)

HR 1.21 (95% CI 0.78–1.89)

Ma et al. [81]

2011

USA

Not reported

30.0–<35.0

HR 2.98 (95% CI 2.30–3.87)

CV

Relative to BMI 18.5 to <20.0

≥ 35.0

HR 5.25 (95% CI 3.89–7.07)

Ma et al. [82]

2013

USA

Not reported

30.0–34.9 (never smoked)

HR 3.22 (95% CI 2.11–4.91) (age 18–44)

HR 1.94 (95% CI 1.51–2.49) (age 45–64)

HR 1.16 (95% CI 1.06–1.28) (age 65–99)

CV

Relative to normal weight (BMI 18.5–24.9) never smoked

30.0–34.9 (former smoker)

HR 3.68 (95% CI 2.09–6.50) (age 18–44)

HR 2.50 (95% CI 2.05–3.05) (age 45–64)

HR 1.39 (95% CI 1.21–1.59) (age 65–99)

30.0–34.9 (current smoker)

HR 7.00 (95% CI 4.66–10.51) (age 18–44)

HR 4.08 (95% CI 3.21–5.18) (age 45–64)

HR 2.21 (95% CI 1.76–2.76) (age 65–99)

≥ 35.0 (never smoked)

HR 8.27 (95% CI 4.95–13.81) (age 18–44)

HR 3.26 (95% CI 2.49–4.28) (age 45–64)

HR 1.19 (95% CI 0.98–1.44) (age 65–99)

≥ 35.0 (former smoker)

HR 5.39 (95% CI 2.68–10.83) (age 18–44)

HR 3.80 (95% CI 2.80–5.15) (age 45–64)

HR 1.68 (95% CI 1.36–2.07) (age 65–99)

≥ 35.0 (current smoker)

HR 12.20 (95% CI 7.73–19.27) (age 18–44)

HR 4.99 (95% CI 3.36–7.42) (age 45–64)

HR 2.17 (95% CI 1.37–3.43) (age 65–99)

McAuley et al. [83]

2014

USA

Not reported

≥ 30.0

HR 1.76 (95% CI 1.17–2.67)

CV

Relative to normal weight (BMI 18.5–24.9)

Payvar et al. [84]

2013

USA

Not reported

> 40.0

OR 1.14 (95% CI 1.04–1.25)

CV (all in-hospital mortality post percutaneous coronary intervention

Relative to BMI 20.0–25.0

OR 1.22 (95% CI 1.08–1.39)

CV (mortality following percutaneous coronary intervention following presentation with STEMI)

Iyen et al. [61]

2021

UK

Not reported

Trajectory 2: 33.7 → 34.9

HR 1.44 (95% CI 1.31–1.58)

CV

(Trajectories over 10 years) Relative to trajectory 1: BMI 28.7 → 29.7

Trajectory 3: 39.9 → 41.1

HR 2.06 (95% CI 1.86–2.29)

Trajectory 4: 49.1 → 49.8

HR 3.31 (95% CI 2.84–3.86)

Silventoinen et al. [67]

2014

Sweden

Not reported

≥ 30.0

HR 2.35 (95% CI 1.81–3.05)

CV

Relative to BMI 20.1–22.4

HR 2.08 (95% CI 1.56–2.77)

Stroke

Bo et al. [76]

2012

Italy

Not reported

> 30.0 (insulin resistant)

HR 2.43 (95% CI 1.57–3.29)

CV

Relative to BMI < 25.0, insulin sensitive

> 30.0 (insulin sensitive)

HR 2.95 (95% CI 1.03–3.98)

Calori et al. [77]

2011

Italy

Not reported

≥ 30.0 (insulin resistant)

HR 1.52 (95% CI 1.02–2.26)

CV

Relative to BMI < 30, insulin sensitive

≥ 30.0 (insulin sensitive)

HR 1.04 (95% CI 0.32–3.30)

Alvi et al. [62]

2015

USA

Not reported

30.0–35.0

OR 0.64 (95% CI 0.05–8.36)

Total knee arthroplasty

Relative to normal weight (BMI 18.5–25.0)

35.0–40.0

OR 1.56 (95% CI 0.21–11.50)

> 40.0

OR 0.90 (95% CI 0.09–9.54)

Sing et al. [63]

2016

USA

Not reported

8.5 → 40.0

0.03% trend in absolute risk of mortality across BMI increase

Total knee arthroplasty

 

Sundara et al. [64]

2019

USA

Not reported

30.0–39.9

OR 0.125 (95% CI 0.011–1.385)

Total knee arthroplasty

Relative to normal weight (BMI 18.5–24.9)

≥ 40.0

OR 0.000 (95% CI 0.000)

Andersen et al. [65]

2015

Denmark

Not reported

≥ 30.0

HR 0.53 (95% CI 0.49–0.57)

Stroke

Relative to normal weight (BMI 18.5–24.9)

Hoffman et al. [66]

2020

USA

Not reported

30–39.9

OR 0.62 (95% CI 0.56–0.69)

Stroke

Relative to BMI < 30.0

≥ 40.0

OR 0.76 (95% CI 0.66–0.88)

Skolarus et al. [68]

2014

USA

Not reported

33.0–34.0

HR 0.75a

Stroke

Relative to BMI 24

35.0–36.0

HR 0.6a

37.0–38.0

HR 0.5a

39.0–41.0

HR 1.0a

≥ 42.0

HR 1.5a

  1. BMI body mass index, CI confidence interval, CV cardiovascular, HR hazard ratio, OR odds ratio, STEMI ST-elevation myocardial infarction, T2D type 2 diabetes
  2. aEstimated results taken from graph (not tabulated)