Key result
BMI ≥30 is linked to ~32% lower hospital mortality in critically ill patients.
Why the study?
The level of BMI associated with the lowest mortality in critically ill Asian patients was uncertain.
Does body mass index affect hospital mortality in critically ill patients in Korea?
Cohort (n=3,655)
Yes
Does body mass index affect hospital mortality in critically ill patients in Korea?
Hazard Ratio: 0.68 (95% CI 0.43–1.08)
Absolute Event Rate: 18.2% vs 18.2%
p-value: p=0.02
In critically ill Korean patients, there is a graded inverse association between BMI and hospital mortality, supporting the existence of an obesity paradox in this population.
Supports obesity paradox in Korean ICU patients; hypothesis-generating and should not yet change practice.
BACKGROUND: The level of body mass index (BMI) that is associated with the lowest mortality in critically ill patients in Asian populations is uncertain. We aimed to examine the association of BMI with hospital mortality in critically ill patients in Korea. METHODS: We conducted a prospective multicenter cohort study of 3,655 critically ill patients in 22 intensive care units (ICUs) in Korea. BMI was categorized into five groups: <18.5, 18.5 to 22.9, 23.0 to 24.9 (the reference category), 25.0 to 29.9, and ≥30.0 kg/m2. RESULTS: The median BMI was 22.6 (IQR 20.3 to 25.1). The percentages of patients with BMI<18.5, 18.5 to 22.9, 23.0 to 24.9, 25.0 to 29.9, and ≥30.0 were 12, 42.3, 19.9, 22.4, and 3.3%, respectively. The Cox-proportional hazard ratios with exact partial likelihood to handle tied failures for hospital mortality comparing the BMI categories <18.5, 18.5 to 22.9, 25.0 to 29.9, and ≥30.0 with the reference category were 1.13 (0.88 to 1.44), 1.03 (0.84 to 1.26), 0.96 (0.76 to 1.22), and 0.68 (0.43 to 1.08), respectively, with a highly significant test for trend (p = 0.02). CONCLUSIONS: A graded inverse association between BMI and hospital mortality with a strong significant trend was found in critically ill patients in Korea.
No takes yet. Share an insight, caveat, or question.
Lim et al. (2014) conducted a cohort in Critical illness requiring intensive care (n=3,655). Body Mass Index (BMI) vs. BMI 23.0 to 24.9 kg/m2 was evaluated on Hospital mortality (HR 0.68, 95% CI 0.43-1.08, p=0.02). Higher body mass index was inversely associated with hospital mortality in critically ill patients, demonstrating a significant graded trend (p=0.02) where BMI ≥30.0 kg/m2 had an adjusted HR of 0.68 compared to BMI 23.0-24.9 kg/m2.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: