Abstract
Background
The correlation between baseline body mass index (BMI) and 30-day in-hospital mortality among patients with sepsis remains inadequately explored in existing literature. Thus, this study endeavors to elucidate the association between baseline BMI and 30-day in-hospital mortality among sepsis patients admitted to the intensive care unit (ICU).
Methods
The author conducted a multicenter retrospective cohort study using data from 17,510 ICU patients with sepsis from the US eICU-CRD v2.0 database spanning 2014 to 2015. The study employed binary logistic regression, subgroup analyses, and smooth curve fitting to examine the relationship between BMI and 30-day in-hospital mortality.
Results
The prevalence of 30-day in-hospital mortality was 16.7% (2929 out of 17,510). The median BMI for sepsis patients was 28.9 kg/m². After adjusting for covariates, our analysis revealed an inverse association between BMI and 30-day in-hospital mortality, with an odds ratio (OR) of 0.99 (95% CI: 0.99, 0.99). Subgroup analyses supported the robustness of these findings. Furthermore, we observed a nonlinear relationship between BMI and 30-day in-hospital mortality, with an inflection point at 21.5 kg/m². On the left side of the inflection point, the effect size (OR) was 0.91 (95% CI: 0.87, 0.94), while on the right side, the relationship was not statistically significant.
Conclusion
The study establishes an independent negative association between baseline BMI and 30-day in-hospital mortality among sepsis patients in the ICU. Furthermore, a non-linear relationship with a saturation effect was observed, suggesting that the 30-day in-hospital mortality rate of sepsis patients is lowest around a BMI of 21.5 kg/m².