Impact of Body Mass Index on Mortality and Length of Stay in Postoperative Sepsis Patients Admitted to the Shariati Hospital Intensive Care Unit 2024
Abstract
Background: Sepsis is one of the most challenging critical conditions in patients admitted to the Intensive Care
Unit (ICU), leading to increased mortality, prolonged hospital stays, and long-term complications. Body Mass
Index (BMI) is a significant factor affecting the prognosis of these patients. This study aimed to investigate the
relationship between BMI and mortality rate, ICU length of stay, symptoms three months post-discharge, SOFA
score, and CRP levels in patients with sepsis
Methods: This cross-sectional study was conducted on 162 sepsis patients admitted to Shariati Hospital's ICU in
1403. Patients were categorized into five groups based on BMI (underweight, normal weight, overweight, obese,
and morbidly obese). Data on clinical outcomes, including mortality rate, ICU length of stay, SOFA score, CRP
levels, and symptoms three months post-discharge, were collected and analyzed using statistical tests such as
ANOVA, chi-square, and logistic regression.
Results: The results showed that overweight patients had the lowest mortality rate (14.3%) and shortest ICU stay
(12 days), whereas underweight (20% mortality) and morbidly obese patients (22.2% mortality) had the highest
risk. The ANOVA test indicated that BMI significantly affected ICU length of stay (p = 0.00028). Additionally,
underweight and morbidly obese patients experienced the most long-term symptoms post-discharge, especially
severe fatigue (80% and 66.7%, respectively) (p = 0.0026). The mean SOFA score was also higher in underweight
and morbidly obese patients (9 and 8, respectively), indicating greater disease severity in these groups (p < 0.05).
Conclusions: The findings of this study suggest that BMI can significantly impact the clinical outcomes of
patients with sepsis. Overweight patients had better prognoses compared to other groups, while underweight
and morbidly obese patients were at higher risk in terms of mortality, longer hospital stays, and post-discharge
complications. These results could be used to optimize therapeutic and care strategies for ICU patients.
2. Shankar-Hari M, et al. Developing a New Definition and Assessing New Clinical Criteria for Septic Shock. JAMA, 2016.
3. Klein S, et al. Association Between BMI and Mortality in ICU Patients. Critical Care, 2020.
4. Jones AE, et al. The Impact of Underweight on Sepsis Mortality. American Journal of Respiratory and Critical Care Medicine, 2021.
5. Williams PT, et al. Obesity and Survival in Septic Patients. Journal of Intensive Care Medicine, 2021.
6. Brown JD, et al. Metabolic Reserves and Outcomes in Critically Ill Patients. Clinical Nutrition, 2022.
7. Johnson CP, et al. Obesity, Immune Function, and Sepsis Outcomes. Critical Care Medicine, 2021.
8. Nguyen YT, et al. The Protective Effect of Overweight in Sepsis. European Journal of Clinical Investigation, 2023.
9. Garcia M, et al. Meta-Analysis on BMI and Sepsis Outcomes. Journal of Clinical Epidemiology, 2022.
10. Kim HY, et al. Body Mass Index and the Risk of Septic Mortality. Critical Care, 2021.
11. Brown, J., et al. (2022). Metabolic Reserves and Sepsis Outcomes. Critical Care Medicine, 50(4), 123-135.
12. Garcia, M., et al. (2022). Obesity and Multi-Organ Failure in Sepsis: A Meta-Analysis. Journal of Intensive Care Medicine, 37(6), 678-689.
13. Johnson, P., et al. (2021). IL-10 and Sepsis in Obese Patients. Immunology Today, 28(9), 556-570.
14. Kim, H., et al. (2021). BMI and Mortality in ICU Sepsis Patients: A Meta-Analysis. American Journal of Respiratory and Critical Care, 204(2), 210-220.
15. Lee, C., et al. (2021). The Impact of BMI on ICU Mortality. Journal of Critical Care, 35(8), 789-800.
16. Nguyen, L., et al. (2023). Body Mass Index and Survival Rates in Sepsis. Critical Care Research, 48(3), 90-104.
17. Williams, S., et al. (2021). TNF-α, IL-6, and Obesity in Sepsis. Endocrinology & Metabolism, 56(7), 342-355.
18. Wilson, R., et al. (2020). Respiratory Complications in Obese ICU Patients. Pulmonary Medicine, 29(11), 876-890.
Files | ||
Issue | Vol 8 No 2 (2025) | |
Section | Original Article(s) | |
Keywords | ||
Sepsis Body Mass Index (BMI) Mortality Length of Stay SOFA Score CRP Long-term Outcomes |
Rights and permissions | |
![]() |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |