• 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, and Korean study group on respiratory failure (KOSREF).
• Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
• Plos One. 2014 Jan 1; 9 (4): e90039.

BackgroundThe 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.MethodsWe 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.ResultsThe 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).ConclusionsA graded inverse association between BMI and hospital mortality with a strong significant trend was found in critically ill patients in Korea.

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