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However, few studies have been large enough to reliably examine the associations between body mass index (BMI) and delirium, especially in critically ill patients. The objective of this study was to investigate the association between BMI and delirium incidence in critically ill patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Data were collected from the Medical Information Mart for Intensive Care-IV V2.0 Database consisting of critically ill participants between 2008 and 2019 at the Beth Israel Deaconess Medical Center in Boston.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 20 193 patients with BMI and delirium records were enrolled in this study and were divided into six groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>Delirium incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Generalised linear models and restricted cubic spline analysis were used to estimate the associations between BMI and delirium incidence. A total of 30.81% of the patients (6222 of 20 193) developed delirium in the total cohort. Compared with those in the healthy weight group, the patients in the different groups (underweight, overweight, obesity grade 1, obesity grade 2, obesity grade 3) had different relative risks (RRs): RR=1.10, 95% CI=1.02 to 1.19, p=0.011; RR=0.93, 95% CI=0.88 to 0.97, p=0.003; RR=0.88, 95% CI=0.83 to 0.94, p&lt;0.001; RR=0.94, 95% CI=0.86 to 1.03, p=0.193; RR=1.14, 95% CI=1.03 to 1.25, p=0.010, respectively. For patients with or without adjustment variables, there was an obvious U-shaped relationship between BMI as a continuous variable and delirium incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BMI was associated with the incidence of delirium. Our results suggested that a BMI higher or lower than obesity grade 1 rather than the healthy weight in critically ill patients increases the risk of delirium incidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-079140","type":"journal-article","created":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T00:15:14Z","timestamp":1711412114000},"page":"e079140","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Association between body mass index and delirium incidence in critically ill patients: a retrospective cohort study based on the MIMIC-IV Database"],"prefix":"10.1136","volume":"14","author":[{"given":"Jianlei","family":"Fu","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China"},{"name":"Department of Critical Care Medicine, Tibet Autonomous Region People's Hospital, Lhasa, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9840-1387","authenticated-orcid":false,"given":"Xuepeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China"},{"name":"Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Canzheng","family":"Wei","sequence":"additional","affiliation":[{"name":"Critical Care Medicine, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinyi","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiying","family":"Gui","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Tibet Autonomous Region People's Hospital, Lhasa, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9289-9660","authenticated-orcid":false,"given":"Yi","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0219-3558","authenticated-orcid":false,"given":"Siyuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"key":"2025121601055180000_14.3.e079140.1","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1007\/s00134-021-06503-1","article-title":"Delirium in critical illness: clinical manifestations, outcomes, and management","volume":"47","author":"Stollings","year":"2021","journal-title":"Intensive Care Med"},{"key":"2025121601055180000_14.3.e079140.2","unstructured":"Devlin JW , Skrobik Y , Gelinas C , et al . 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