PLoS ONE (Jan 2014)

Body mass index and mortality in Korean intensive care units: a prospective multicenter cohort study.

  • So Yeon Lim,
  • Won-Il Choi,
  • Kyeongman Jeon,
  • Eliseo Guallar,
  • Younsuck Koh,
  • Chae-Man Lim,
  • Shin Ok Koh,
  • Sungwon Na,
  • Young-Joo Lee,
  • Seok Chan Kim,
  • Ick Hee Kim,
  • Je Hyeong Kim,
  • Jae Yeol Kim,
  • Jaemin Lim,
  • Chin Kook Rhee,
  • Sunghoon Park,
  • Ho Cheol Kim,
  • Jin Hwa Lee,
  • Jisook Park,
  • Gee Young Suh,
  • Validation of Simplified acute physiology score 3 in Korean Intensive care unit (VSKI) study group,
  • Korean study group on respiratory failure (KOSREF)

DOI
https://doi.org/10.1371/journal.pone.0090039
Journal volume & issue
Vol. 9, no. 4
p. e90039

Abstract

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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.