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July 1, 2025Clinical Nutrition ESPENOpen Access

Higher BMI linked to lower 30-day mortality in critically ill patients.

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Why the study?

Although obesity is linked to higher mortality generally, its relationship with critical illness is complex, prompting evaluation of whether BMI predicts 30-day mortality and lengths of stay in critically ill patients.

Does BMI predict 30-day mortality and ICU/hospital length of stay in critically ill patients?

Population

Over 5400 critically ill patients

Comparison

Different BMI categories compared to normal weight

Design

Retrospective study

Follow-up

30-day

Key result

Higher BMI, particularly class II obesity, was associated with lower 30-day mortality in critically ill patients, while another unspecified BMI category showed higher mortality (HR 1.44, p=0.006).

Authors

LGLaurence GentonUniversity of GenevaVMValeria A Bertoni MalufUniversity of GenevaFHFrançois R. HerrmannUniversity of Geneva

Discussion

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Member takes

Overview

Should not yet alter ICU nutrition or triage by BMI; extends obesity paradox observations but remains hypothesis-generating.

Study Design

Type

Cohort (n=5,400)

Structured PICO

Does BMI predict 30-day mortality and ICU/hospital length of stay in critically ill patients?

P
Population
Over 5400 critically ill patients
I
Intervention
Higher BMI (overweight, obesity class I, and obesity class II)
C
Comparator
Normal weight
O
Outcome
30-day mortalityhard clinical

Main Result

Effect estimate: HR 1.44

p-value: p=0.006

In critically ill patients, higher BMI is associated with lower 30-day mortality but longer hospital and ICU lengths of stay, reflecting the obesity paradox.

Cite This Study

Genton et al. (2025) conducted a cohort in Critically ill patients (n=5,400). Higher BMI (overweight, obesity class I and II) vs. Normal weight was evaluated on 30-day mortality (HR 1.44, p=0.006). Higher BMI, particularly class II obesity, was associated with lower 30-day mortality in critically ill patients, while another unspecified BMI category showed higher mortality (HR 1.44, p=0.006).

synapsesocial.com/papers/6a182e7bcf49e78c48b4e5c9https://doi.org/10.1016/j.clnesp.2025.06.046
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