Outcomes of patients based on BMI categories.

BackgroundThe “obesity paradox” in certain diseases has been reported in previous studies. This study aimed to investigate the relationship between BMI and long-term mortality in all critically ill patients without malignant tumors who were admitted to the ICU.MethodsUsing the MIMIC-IV 2.2 database, we included all ICU admissions for patients without malignant tumors and categorized them into four groups based on the World Health Organization (WHO) obesity criteria. The relationship between BMI and 90-day, 180-day, and 1-year mortality was analyzed using univariate and multivariate Cox regression models, along with restricted cubic spline (RCS) models to account for potential non-linear associations.ResultsA total of 19,089 patients were included, with 90-day, 180-day, and 1-year mortality rates of 18.35%, 20.80%, and 23.96%, respectively. Overweight and obese patients exhibited significantly lower mortality rates compared to underweight and normal-weight individuals at all time points. After adjusting for confounders, higher BMI remained a protective factor for long-term mortality (HR 0.65–0.72, P ConclusionThe “obesity paradox” may apply to critically ill patients without malignant tumors.