Introduction Obesity is closely associated with ischemic stroke risk and has a nearly-linear relationship.

Aim of Study Since the association between stroke and obesity may differ depending on pathophysiology of the stroke subtype based on the causative factors of stroke, this study aimed to explain the relationship between body mass index (BMI) and functional prognosis according to stroke subtype.

Methods A prospective institutional database on stroke was accessed from March 2014 to December 2021 (4,509 patients); consecutive patients with ischemic stroke were selected retrospectively. Multivariate logistic analysis of the complete-case, multiple imputation (MI), and propensity score-matched analysis (PSM) database sets was conducted to evaluate the relationship between BMI and functional outcomes.

Results Finally, 2,779 patients were enrolled according to the inclusion criteria. For logistic regression analysis of the three stroke subtypes such as large artery disease (LAD), cardioembolism (CE), small vessel occlusion (SVO), the final PSM analysis showed significantly favorable results in the overweight and obese patient groups (OR 0.38, 95% CI 0.20–0.74; OR 0.40, 95% CI 0.21–0.76, respectively) in the case of CE. In the SVO group, favorable outcome was observed in the obese group (OR 0.55, 95% CI 0.32–0.95), whereas in the LAD group, no significant difference was observed in functional outcomes.

Conclusion CE showed a favorable outcome in the overweight and obese patient groups compared to the normal weight group. SVD revealed that only the obese patient group had a favorable outcome; however, an association was not observed in the LAD patient group.

Disclosure of Interest none