Body Mass Index and Mortality Among Hospitalized Patients with a COPD-Coded Diagnosis in MIMIC-IV
Year: 2026
Type: article
Study design: Observational Study
Abstract: Purpose: To examine associations between body mass index (BMI) and in-hospital, 30-day, 90-day, and 360-day all-cause mortality among hospitalized patients with a COPD-coded diagnosis. Patients and Methods: This retrospective cohort study included 9228 patients from a MIMIC-IV analysis extract. BMI was classified as underweight, normal weight, overweight, or obesity. In-hospital mortality was analyzed using logistic regression and follow-up mortality using Cox regression. Restricted cubic splines, proportional-hazards diagnostics, landmark analyses, sensitivity analyses, and multiplicity correction were performed. Results: There were 387 in-hospital deaths and 585, 1038, and 1969 deaths by 30, 90, and 360 days, respectively. Compared with normal weight, Model 3 HRs for 90-day mortality were 1.523 (95% CI 1.178-1.969) for underweight, 0.809 (0.687-0.952) for overweight, and 0.789 (0.673-0.926) for obesity. Corresponding 360-day HRs were 1.374 (1.134-1.666), 0.742 (0.659-0.835), and 0.713 (0.635-0.801). Overweight and obesity were not significantly associated with in-hospital or 30-day mortality after full adjustment. Associations were nonlinear, and global proportional-hazards tests were significant. After Holm correction, the 90-day overweight comparison was no longer statistically significant. Conclusion: BMI was associated with mortality, with the most consistent inverse associations for overweight and obesity at 360 days. These observational findings do not establish a survival benefit of obesity and remain susceptible to reverse causation and residual confounding.
Source: International Journal of COPD
DOI: 10.2147/copd.s639532
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,836
OpenAlex ID: W7223460440