The body mass index as a prognostic factor of critical care.
OBJECTIVE
Obesity is a worldwide concern, but its influence on critical care outcomes is not well understood. We tested the hypothesis that abnormal body mass index (BMI) would be an independent predictor of higher mortality rates in intensive care unit (ICU).


METHODS
We retrospectively reviewed patients who had admitted to the ICU from January 2007 to December 2007. Admission BMI was analyzed as both a three categorical (underweight, < 18.5 kg/m(2); normal weight, 18.5 to 24.9 kg/m(2); overweight and obese, > or = 25 kg/m(2)) and continuous variables among all patients with an ICU length of stay > or = 4 days. The primary outcome was ICU mortality.


RESULTS
The multivariate analysis on ICU mortality selected Mortality Prediction Model-Admission (MPM at time zero) (hazard ratio [HR], 1.024; p = 0.001; 95% confidence interval [CI], 1.010 to 1.037), failed extubation (HR, 5.092; p = 0.0001; 95% CI, 2.742 to 9.456) as significant risk factors. When controlling these variables, none of the BMI group and BMI as a continuous variable had an independent association with ICU mortality.


CONCLUSIONS
BMI did not have a significant influence on ICU mortality. The ICU mortality was influenced more strongly by severity of illness and failed extubation rather than BMI.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
So Yeon
SY
Lim
So I
SI
Kim
Yon Ju
YJ
Ryu
Jin Hwa
JH
Lee
Eun Mi
EM
Chun
Jung Hyun
JH
Chang
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003422:Critical Care / Q000706:statistics & numerical data*; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013851:Thinness / Q000401:mortality