Key result
Higher BMI linked to lower 30-day mortality in critically ill patients.
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?
Cohort (n=5,400)
Does BMI predict 30-day mortality and ICU/hospital length of stay in critically ill patients?
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.
Answers are grounded in this paper and cite their sources.
Should not yet alter ICU nutrition or triage by BMI; extends obesity paradox observations but remains hypothesis-generating.
The aim of this study was to determine whether BMI predicted 30-day mortality (primary outcome) and intensive care unit (ICU) and hospital lengths of stay (LOS) (secondary outcome) in critically ill patients. METHODS: ). The association between BMI and outcomes was assessed by multivariate Cox Lasso (Least absolute shrinkage and selection operator) or linear Lasso regression models, adjusted for age, sex, Simplified Acute Physiology Score (SAPS) II, primary diagnosis (ICD-10 codes) and measurement time points. RESULTS: (HR 1.44, p = 0.006) compared to normal weight. BMI categories in the overweight, obesity class I and class II range were all associated with longer ICU and hospital LOS (all p < 0.05). CONCLUSION: Patients with higher BMI, particularly with class II obesity, show a lower 30-day mortality in ICU settings, but a longer ICU and hospital LOS. This is likely a reflection of the obesity paradox and the complex role of body composition in critical illness outcomes. CLINICAL TRIAL REGISTRY: clinicaltrials.gov, identifier: NCT05834894.
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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.
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