Obesity paradox in sepsis: a systematic review and meta-analysis of short- and long-term mortality risks.
Med Intensiva (Engl Ed)Jul 16, 2026 (epub)
Sa Yang, Shuying Yang, Hongjie Li et al.
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In 30 seconds
This systematic review and meta-analysis examined the relationship between elevated BMI and mortality in 130,755 adult sepsis patients. The study found that an elevated BMI was associated with reduced short-term mortality (OR 0.75) and long-term mortality (OR 0.68), supporting the obesity paradox. The inverse association was also evident in patients with a BMI ≥ 40 kg/m² (OR 0.70).
Key findings
- Elevated BMI was linked to reduced short-term mortality (OR 0.75, 95% CI 0.69-0.81).
- 28-/30-day mortality was lower in patients with elevated BMI (OR 0.74, 95% CI 0.68-0.81).
- Long-term mortality was also reduced with elevated BMI (OR 0.68, 95% CI 0.60-0.77).
- The inverse association persisted in patients with BMI ≥ 40 kg/m² (OR 0.70, 95% CI 0.62-0.79).
Why it matters
Understanding the relationship between BMI and mortality in sepsis can inform clinical decision-making and risk assessment. The findings challenge traditional views on obesity and highlight the complexity of patient outcomes in critical illness.