Underweight status in patients hospitalized with acute pulmonary embolism was associated with higher in-hospital mortality compared to normal BMI (7.8% vs 3.3%; OR 1.85, 95% CI 1.54-2.21; p<0.001).
Observational (n=904,260)
Yes
Does body mass index category impact in-hospital mortality and management in adult admissions with acute pulmonary embolism?
In patients hospitalized with acute pulmonary embolism, being underweight is associated with significantly higher in-hospital mortality and complications, while being overweight or obese is associated with lower mortality compared to normal BMI.
Odds Ratio: 1.85 (95% CI 1.54–2.21)
Absolute Event Rate: 7.8% vs 3.3%
p-value: p=<0.001
Background: Limited data exist on the impact of body mass index (BMI) on the outcomes of admissions with acute pulmonary embolism (PE). Methods: All adult (≥18 years) admissions with a primary diagnosis of PE were identified using the National Inpatient Sample (2016-2020) and categorized using BMI into underweight (24. 9 kg/m 2). Outcomes included in-hospital mortality, utilization of PE therapies, and resource utilization. Results: Of 904, 260 admissions, 1. 8%, 70. 4%, and 27. 7% were underweight, normal and overweight/obese, respectively. Underweight admissions were on average older (70. 8±0. 2, 64. 6±0. 05, 58. 2±0. 07 years), male (56. 7%, 49%, 58. 3%) with higher comorbidity (Elixhauser Index 5. 8±0. 03, 4±0. 06, 5. 1±0. 09), from a lower socioeconomic status, and with Medicare insurance compared to normal and overweight/obese categories (p<0. 001). The underweight cohort had higher rates of acute organ failure, bleeding complications, strokes, shock, and higher mechanical ventilation and hemodialysis use. In contrast to the underweight group, normal and overweight/obese groups had higher rates of mechanical thrombectomy (0. 3%, 1. 1%, 1. 9%), systemic thrombolysis (1. 5%, 2. 6%, 4. 2%), catheter directed therapy (0. 9%, 3%, 5. 8%), and surgical thrombectomy (0. 0%, 0. 1%, 0. 2%) (p<0. 001). Compared to the normal cohort (3. 3%), underweight cohort had higher (7. 8%; odds ratio OR 1. 85 95% confidence interval CI 1. 54-2. 21), whereas the overweight/obese cohort had lower (2. 2%; OR 0. 47 95% CI 0. 42-0. 52) in-hospital mortality (both p <0. 001). The underweight cohort had longer hospitalization stays, higher hospitalization costs, and were discharged home less frequently. Conclusion: Compared to those with normal BMI, underweight status was associated with worse outcomes in those hospitalization with acute PE.
Mehta et al. (2026) conducted an observational in Acute pulmonary embolism (n=904,260). Underweight status (BMI <19.9 kg/m2) vs. Normal BMI (19.9-24.9 kg/m2) was evaluated on In-hospital mortality (OR 1.85, 95% CI 1.54-2.21, p=<0.001). Underweight status in patients hospitalized with acute pulmonary embolism was associated with higher in-hospital mortality compared to normal BMI (7.8% vs 3.3%; OR 1.85, 95% CI 1.54-2.21; p<0.001).