RT Journal Article SR Electronic T1 Impact of body mass index on survival of medical patients with sepsis: a prospective cohort study in a university hospital in China JF BMJ Open JO BMJ Open FD British Medical Journal Publishing Group SP e021979 DO 10.1136/bmjopen-2018-021979 VO 8 IS 9 A1 Qingtao Zhou A1 Meng Wang A1 Shuo Li A1 Jing Zhang A1 Qingbian Ma A1 Yanling Ding A1 Hongxia Ge A1 Ning Shen A1 Yaan Zheng A1 Yongchang Sun YR 2018 UL http://bmjopen.bmj.com/content/8/9/e021979.abstract AB Objective To evaluate the impact of body mass index (BMI) on survival of a Chinese cohort of medical patients with sepsis.Design A single-centre prospective cohort study conducted from May 2015 to April 2017.Setting A tertiary care university hospital in China.Participants A total of 178 patients with sepsis admitted to the medical intensive care unit (ICU) were included.Main outcome measures The primary outcome was 90-day mortality while the secondary outcomes were in-hospital mortality, length of ICU stay and length of hospital stay.Results The median age (IQR) was 78 (66–84) years old, and 77.0% patients were older than 65 years. The 90-day mortality was 47.2%. The in-hospital mortality was 41.6%, and the length of ICU stay and hospital stay were 12 (5–22) and 15 (9–28) days, respectively. Cox proportional hazard regression analysis identified that Sequential Organ Failure Assessment score (HR=1.229, p<0.001), Acute Physiology and Chronic Health Evaluation II score (HR=1.050, p<0.001) and BMI (HR=0.940, p=0.029) were all independently associated with the 90-day mortality. Patients were divided into four groups based on BMI (underweight 33 (18.5%), normal 98 (55.1%), overweight 36 (20.2%) and obese 11 (6.2%)). The 90-day mortality (66.7%, 48.0%, 36.1% and 18.2%, p=0.015) and in-hospital mortality (60.6%, 41.8%, 30.6% and 18.2%, p=0.027) were statistically different among the four groups. Differences in survival among the four groups were demonstrated by Kaplan-Meier survival analysis (p=0.008), with the underweight patients showing a lower survival rate.Conclusions BMI was an independent factor associated with 90-day survival in a Chinese cohort of medical patients with sepsis, with patients having a lower BMI at a higher risk of death.