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October 2007

Improving the Assessment of the Relationship Between Body Mass Index and Hospital Discharge After Ischemic Stroke—Reply

Arch Neurol. 2007;64(10):1546. doi:10.1001/archneur.64.10.1546-a

In reply

We thank Drs Hamilton and Filardo for their interest in our article. Indeed, categorization of BMI according to the US Preventive Services Task Force1 may have its drawbacks, but this approach has been used in several other studies,2-4 probably because these categorizations may be more clinically meaningful than simply reporting a difference between overall BMI means. The task force report emphasized these distinctions to foster practical use in routine clinical care.1 It is this same premise (ease of assessment and management) that underlies the persistent use of BMI as an index of obesity in various clinical studies rather than the more cumbersome measurements of abdominal obesity, the latter of which plays a more direct role in the development of various metabolic abnormalities and correlates much better with extent of total adiposity.5