{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T16:07:38Z","timestamp":1784736458553,"version":"3.55.0"},"reference-count":35,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:sec><jats:title\/><\/jats:sec><jats:sec><jats:title>OBJECTIVES:<\/jats:title><jats:p>To explore the hypothesis that obesity is associated with increased mortality and worse outcomes in children who are critically ill.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>Secondary analysis of the Assessment of Worldwide Acute Kidney Injury, Renal Angina, and Epidemiology study, a prospective, multinational observational study. Patients between 3 months and 25 years across Asia, Australia, Europe, and North America were recruited for 3 consecutive months. Patients were divided into 4 groups (underweight, normal weight, overweight, and obese) on the basis of their BMI percentile for age and sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>A total of 3719 patients were evaluated, of whom 542 (14%) had a primary diagnosis of sepsis. One thousand fifty-nine patients (29%) were underweight, 1649 (44%) were normal weight, 423 (11%) were overweight, and 588 (16%) were obese. The 28-day mortality rate was 3.6% for the overall cohort and 9.1% for the sepsis subcohort and differed significantly by weight status (5.8%, 3.1%, 2.2%, and 1.8% for subjects with underweight, normal weight, overweight, and obesity, respectively, in the overall cohort [P &amp;lt; .001] and 15.4%, 6.6%, 3.6%, and 4.7% in the sepsis subcohort, respectively [P = .003]). In a fully adjusted model, 28-day mortality risk was 1.8-fold higher in the underweight group versus the normal weight group in the overall cohort and 2.9-fold higher in the sepsis subcohort. Patients who were overweight and obese did not demonstrate increased risk in their respective cohorts. Patients who were underweight had a longer ICU length of stay, increased need for mechanical ventilation support, and a higher frequency of fluid overload.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Patients who are underweight make up a significant proportion of all patients in the PICU, have a higher short-term mortality rate, and have a more complicated ICU course.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2019-2829","type":"journal-article","created":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T12:25:49Z","timestamp":1593779149000},"source":"Crossref","is-referenced-by-count":19,"title":["Weight as a Risk Factor for Mortality in Critically Ill Patients"],"prefix":"10.1542","volume":"146","author":[{"given":"Itay","family":"Ayalon","sequence":"first","affiliation":[{"name":"Pediatric Intensive Care Unit, Dana-Dwek Children\u2019s Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica G.","family":"Woo","sequence":"additional","affiliation":[{"name":"Divisions of Biostatistics and Epidemiology and"},{"name":"Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajit K.","family":"Basu","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Children's Healthcare of Atlanta and Department of Pediatrics, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Kaddourah","sequence":"additional","affiliation":[{"name":"Center for Acute Care Nephrology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart L.","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio; and"},{"name":"Center for Acute Care Nephrology, and"},{"name":"Heart Institute, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio; 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