Key result
In-hospital BMI gain is linked to ~52% higher 28-day mortality in surgical ICU patients.
Why the study?
Does in-hospital BMI change predict 28-day mortality in adult surgical ICU patients admitted via the ED?
Cohort (n=20,543)
Yes
Does in-hospital BMI change predict 28-day mortality in adult surgical ICU patients admitted via the ED?
Hazard Ratio: 1.52 (95% CI 1.27–1.82)
Absolute Event Rate: 7.27% vs 3.77%
p-value: p=<0.0001
In-hospital BMI change is a significant predictor of 28-day mortality in surgical ICU patients, with a moderate reduction (-1.75 kg/m2) associated with the lowest risk.
BMI gain signals higher 28-day mortality risk in surgical ICU patients; leaves open whether monitoring or interventions targeting weight trajectories improve outcomes.
Background The prognostic value of dynamic body mass index (BMI) changes during hospitalization in surgical intensive care unit (ICU) patients admitted emergently remains unclear. This study aimed to investigate the association between in-hospital BMI change and 28-day mortality in this high-risk population. Methods This retrospective cohort study utilized data from the eICU Collaborative Research Database (2014–2015). A total of 20,543 adult surgical ICU patients admitted via the emergency department (ED) were included. BMI change was calculated as discharge BMI minus admission BMI. Multivariable Cox regression, restricted cubic splines, and subgroup analyses were employed to evaluate the association between BMI change and mortality. Results The 28-day ICU mortality was 4.70%. BMI change exhibited a U-shaped, non-linear association with death: risk declined modestly as BMI rose toward the nadir of −1.75 kg/m 2 , then increased sharply thereafter. Each additional kg/m 2 above this threshold raised mortality by 9% (HR 1.09, 95% CI 1.05–1.12, p < 0.0001). Patients in the highest BMI-gain quartile faced a 52% higher risk than those in the lowest quartile (HR 1.52, 95% CI 1.27–1.82, p < 0.0001). Dynamic BMI change outperformed static BMI or weight measures (AUC 57.9). Conclusion In-hospital BMI change is a significant predictor of 28-day mortality in surgical ICU patients admitted via the ED. A moderate reduction in BMI (−1.75 kg/m 2 ) was associated with the lowest mortality risk. Dynamic BMI monitoring may enhance risk stratification and guide personalized fluid management in this population.
No takes yet. Share an insight, caveat, or question.
Yang et al. (2026) conducted a cohort in Critically ill surgical patients (n=20,543). In-hospital body mass index (BMI) change vs. Lowest BMI-gain quartile was evaluated on 28-day ICU mortality (HR 1.52, 95% CI 1.27-1.82, p=<0.0001). In-hospital BMI gain was associated with increased 28-day mortality in surgical ICU patients, with those in the highest BMI-gain quartile facing a 52% higher risk of death than those in the lowest quartile (HR 1.52).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: