Dose-Response Meta-Analysis of the Impact of Body Mass Index on Mortality in the Intensive Care Unit.

INTRODUCTION

Both low and high body mass index (BMI) are associated with mortality in the intensive care unit (ICU). Although many studies have been done to determine the relationship between BMI and risk of mortality in the ICU, their results were inconsistent. This study aimed to conduct a dose-response meta-analysis of published observational studies to assess the effect of BMI on the risk of mortality in patients admitted to the ICU.

METHODS

PubMed, Scopus, and Google Scholar were searched to identify articles up to May 2019. A total of 31 relevant articles, with 238,961 patients and a follow-up period of 1 month to 11 years, were analyzed.

RESULTS

Linear analysis showed a 0.6% decrease in mortality rate per unit (kg/m ) increase in BMI (odds ratio: 0.99; 95% CI, 0.98-0.99). In addition, nonlinear analysis showed a decrease in risk of mortality for a BMI of 35 (P < .001) and then increased the risk of mortality with a BMI > 35 (P < .001).

CONCLUSION

This dose-response meta-analysis revealed that a BMI ≤ 35 can be a protective agent against mortality, but a BMI > 35 is a life-threatening factor in patients admitted to the ICU.