| Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc |
| Journal website https://jem.elmerpub.com |
Original Article
Volume 16, Number 4, August 2026, pages 190-200
Association Between Mortality and Weight Loss in Critical Patients: A Propensity Matching Study
Figures




Tables
| Characteristic | Original cohort | Matched cohort | ||||
|---|---|---|---|---|---|---|
| Group 1 (n = 28,258) | Group 2 (n = 959) | SMD | Group 1 (n = 957) | Group 2 (n = 957) | SMD | |
| Group 1: patients without weight loss. Group 2: patients with weight loss, as defined by ICD-9 diagnoses. SMD: standardized mean difference; SpO2: oxygen saturation; SBP: systolic blood pressure; DBP: diastolic blood pressure; MAP: mean arterial pressure; GCS: Glasgow Coma Score; SOFA: Sequential Organ Failure Assessment; OASIS: Oxford Acute Severity of Illness Score; CHF: congestive heart failure; COPD: chronic obstructive pulmonary disease; WBC: white blood cell count; INR: international prothrombin time; PT: prothrombin time; PTT: partial thromboplastin time; BUN: blood urea nitrogen. | ||||||
| Basic information | ||||||
| Female, n (%) | 11,847 (41.9) | 421 (43.9) | 0.04 | 724 (75.7) | 706 (73.8) | 0.044 |
| Age | 65.20 (52.22, 77.38) | 66.55 (53.79, 78.27) | 0.095 | 68.09 (54.95, 79.59) | 66.55 (53.81, 78.28) | 0.058 |
| Ethnicity, n (%) | 0.094 | 0.044 | ||||
| White | 20,415 (72.2) | 707 (73.7) | 724 (75.7) | 706 (73.8) | ||
| Black | 2,095 (7.4) | 87 (9.1) | 79 (8.3) | 87 (9.1) | ||
| Other | 5,748 (20.3) | 165 (17.2) | 154 (16.1) | 164 (17.1) | ||
| Admission, n (%) | 0.382 | 0.054 | ||||
| Elective | 4,815 (17.0) | 52 (5.4) | 41 (4.3) | 52 (5.4) | ||
| Emergency | 22,711 (80.4) | 890 (92.8) | 900 (94.0) | 888 (92.8) | ||
| Urgent | 732 (2.6) | 17 (1.8) | 16 (1.7) | 17 (1.8) | ||
| Weight, kg | 79.00 (67.00, 93.00) | 69.00 (58.00, 83.00) | 0.425 | 77.00 (65.00, 91.00) | 69.00 (58.00, 83.00) | 0.380 |
| Vital signs | ||||||
| Heart rate, bpm | 83.39 (73.92, 93.75) | 86.84 (76.82, 99.18) | 0.265 | 87.06 (76.45, 98.84) | 86.80 (76.82, 99.00) | 0.033 |
| Respiratory rate, bpm | 17.78 (15.81, 20.28) | 18.48 (16.30, 21.55) | 0.185 | 18.54 (16.32, 21.38) | 18.48 (16.30, 21.54) | < 0.001 |
| Temperature, °C | 36.82 (36.49, 37.20) | 36.80 (36.44, 37.23) | 0.015 | 36.81 (36.44, 37.21) | 36.80 (36.44, 37.23) | 0.012 |
| Spo2, % | 97.64 (96.33, 98.73) | 97.75 (96.33, 98.98) | 0.022 | 97.69 (96.44, 98.80) | 97.75 (96.33, 99.00) | 0.022 |
| SBP, mm Hg | 117.35 (108.04, 129.40) | 115.64 (105.72, 131.16) | 0.041 | 116.86 (107.63, 129.71) | 115.64 (105.72, 131.17) | 0.049 |
| DBP, mm Hg | 60.08 (54.00, 67.15) | 60.35 (53.62, 67.89) | 0.064 | 60.56 (54.85, 68.00) | 60.42 (53.61, 67.91) | 0.022 |
| MAP, mm Hg | 77.23 (71.25, 84.76) | 76.67 (69.68, 85.33) | 0.026 | 77.06 (71.00, 85.44) | 76.75 (69.71, 85.34) | 0.04 |
| Severity of illness | ||||||
| GCS | 15.00 (14.00, 15.00) | 15.00 (13.00, 15.00) | 0.184 | 15.00 (13.00, 15.00) | 15.00 (13.00, 15.00) | 0.046 |
| SOFA | 3.00 (2.00, 5.00) | 4.00 (2.00, 7.00) | 0.32 | 4.00 (2.00, 6.00) | 4.00 (2.00, 7.00) | < 0.001 |
| OASIS | 30.00 (25.00, 36.00) | 33.00 (28.00, 39.00) | 0.382 | 34.00 (28.00, 39.00) | 33.00 (28.00, 39.00) | 0.006 |
| Comorbidities, n (%) | ||||||
| CHF | 6,544 (23.2) | 245 (25.5) | 0.056 | 243 (25.4) | 244 (25.5) | 0.002 |
| Hypertension | 15,567 (55.1) | 448 (46.7) | 0.168 | 456 (47.6) | 448 (46.8) | 0.017 |
| Stroke | 971 (3.4) | 80 (8.3) | 0.21 | 77 (8.0) | 79 (8.3) | 0.008 |
| COPD | 4,861 (17.2) | 196 (20.4) | 0.083 | 182 (19.0) | 195 (20.4) | 0.034 |
| Diabetes mellitus | 7,187 (25.4) | 229 (23.9) | 0.036 | 224 (23.4) | 229 (23.9) | 0.012 |
| Renal failure | 3,409 (12.1) | 156 (16.3) | 0.121 | 165 (17.2) | 156 (16.3) | 0.025 |
| Liver disease | 1,698 (6.0) | 141 (14.7) | 0.288 | 135 (14.1) | 141 (14.7) | 0.018 |
| Malignancy | 2,317 (8.2) | 128 (13.3) | 0.167 | 113 (11.8) | 126 (13.2) | 0.041 |
| Coagulopathy | 2,636 (9.3) | 182 (19.0) | 0.28 | 165 (17.2) | 181 (18.9) | 0.043 |
| Laboratory tests | ||||||
| WBC, × 109/L | 12.30 (9.10, 16.30) | 12.50 (8.80, 17.35) | 0.031 | 12.50 (9.10, 16.90) | 12.50 (8.80, 17.30) | 0.028 |
| Hemoglobin, g/dL | 10.10 (8.60, 11.80) | 9.60 (8.40, 11.00) | 0.21 | 9.70 (8.30, 11.30) | 9.60 (8.40, 11.00) | 0.012 |
| Platelet, × 109/L | 186.00 (134.00, 247.00) | 201.00 (129.00, 282.00) | 0.175 | 196.00 (129.00, 272.00) | 201.00 (129.00, 282.00) | 0.008 |
| Laboratory tests | ||||||
| Hematocrit, % | 29.60 (25.20, 34.40) | 28.50 (24.80, 32.55) | 0.164 | 28.80 (24.70, 33.30) | 28.50 (24.80, 32.60) | 0.01 |
| INR | 1.30 (1.10, 1.50) | 1.30 (1.20, 1.70) | 0.122 | 1.30 (1.10, 1.70) | 1.30 (1.20, 1.70) | 0.042 |
| PT, s | 14.30 (13.10, 16.10) | 14.70 (13.20, 17.85) | 0.166 | 14.70 (13.30, 17.50) | 14.70 (13.20, 17.80) | 0.026 |
| PTT, s | 31.40 (26.80, 41.50) | 32.80 (28.00, 43.20) | 0.051 | 32.50 (27.00, 44.60) | 32.70 (28.00, 43.20) | 0.003 |
| Bun, mg/dL | 19.00 (14.00, 28.00) | 22.00 (14.00, 37.00) | 0.205 | 22.00 (15.00, 35.00) | 22.00 (14.00, 37.00) | 0.005 |
| Creatinine, mg/dL | 1.00 (0.80, 1.30) | 1.00 (0.70, 1.50) | 0.064 | 1.10 (0.80, 1.50) | 1.00 (0.70, 1.50) | 0.011 |
| Potassium, mmol/L | 4.50 (4.10, 5.10) | 4.30 (4.00, 4.80) | 0.218 | 4.30 (4.00, 4.90) | 4.30 (4.00, 4.80) | 0.013 |
| Sodium, mmol/L | 140.00 (138.00, 142.00) | 140.00 (137.00, 143.00) | 0.009 | 141.00 (138.00, 143.00) | 140.00 (137.00, 143.00) | 0.072 |
| Bicarbonate, mmol/L | 25.00 (23.00, 27.00) | 25.00 (22.00, 28.00) | 0.016 | 25.00 (23.00, 27.00) | 25.00 (22.00, 28.00) | 0.018 |
| Chloride, mmol/L | 107.00 (104.00, 111.00) | 107.00 (103.00, 111.00) | 0.005 | 108.00 (104.00, 111.00) | 107.00 (103.00, 111.00) | 0.068 |
| Glucose, mEq/L | 156.00 (125.00, 194.75) | 150.00 (120.00, 196.50) | 0.015 | 154.00 (125.00, 199.00) | 150.00 (120.00, 197.00) | 0.04 |
| Anion gap, mmol/L | 14.00 (12.00, 17.00) | 15.00 (13.00, 18.00) | 0.147 | 15.00 (13.00, 18.00) | 15.00 (13.00, 18.00) | 0.063 |
| Outcomes | Original cohort | Matched cohort | ||||||
|---|---|---|---|---|---|---|---|---|
| Total | Group 1 | Group 2 | P value | Total | Group 1 | Group 2 | P value | |
| Group 1: patients without weight loss. Group 2: patients with weight loss, as defined by ICD-9 diagnoses. ICU: intensive care unit; MV: mechanical ventilation; RRT: renal replacement therapy. | ||||||||
| Primary outcome, n (%) | ||||||||
| 90-day mortality | 2,577 (8.8) | 2,395 (8.5) | 182 (19.0) | < 0.001 | 311 (16.2) | 130 (13.6) | 181 (18.9) | 0.002 |
| 180-day mortality | 3,209 (11.0) | 3,000 (10.6) | 209 (21.8) | < 0.001 | 371 (19.4) | 162 (16.9) | 209 (21.8) | 0.008 |
| 365-day mortality | 4,854 (16.6) | 4,553 (16.1) | 301 (31.4) | < 0.001 | 532 (27.8) | 232 (24.2) | 300 (31.3) | 0.001 |
| Secondary outcome, n (%) | ||||||||
| Vasopressor use (> 24 h) | 3,559 (12.2) | 3,388 (12.0) | 171 (17.8) | < 0.001 | 315 (16.5) | 145 (15.2) | 170 (17.8) | 0.139 |
| RRT | 271 (0.9) | 232 (0.8) | 39 (4.1) | < 0.001 | 48 (2.5) | 9 (0.9) | 39 (4.1) | < 0.001 |
| MV (> 72 h) | 3,176 (10.9) | 2,917 (10.3) | 259 (27.0) | < 0.001 | 395 (20.6) | 136 (14.2) | 259 (27.1) | < 0.001 |
| ICU-stays (>3 days) | 10,214 (35.0) | 9,681 (34.3) | 533 (55.6) | < 0.001 | 911 (47.6) | 380 (39.7) | 531 (55.5) | < 0.001 |
| Hospital-stays (> 14 days) | 5,543 (19.0) | 5,024 (17.8) | 519 (54.1) | < 0.001 | 732 (38.2) | 215 (22.5) | 517 (54.0) | < 0.001 |
| Outcomes | Original cohort | Matched cohort | ||||||
|---|---|---|---|---|---|---|---|---|
| Non-adjusted | Adjusted | Non-adjusted | Adjusted | |||||
| OR (95% CI) | P value | OR (95% CI) | P value | OR (95% CI) | P value | OR (95% CI) | P value | |
| CI: confidence interval; ICU: intensive care unit; MV: mechanical ventilation; OR: odds ratio; RRT: renal replacement therapy. | ||||||||
| Primary outcome | ||||||||
| 90-day mortality | 2.53 (2.14, 2.98) | < 0.001 | 1.59 (1.32, 1.91) | < 0.001 | 1.48 (1.16, 1.90) | 0.002 | 1.65 (1.26, 2.17) | < 0.001 |
| 180-day mortality | 2.35 (2.00, 2.74) | < 0.001 | 1.53 (1.28, 1.82) | < 0.001 | 1.37 (1.09, 1.72) | 0.007 | 1.49 (1.16, 1.93) | 0.002 |
| 365-day mortality | 2.38 (2.07, 2.74) | < 0.001 | 1.57 (1.34, 1.84) | < 0.001 | 1.43 (1.17, 1.75) | 0.001 | 1.56 (1.25, 1.96) | < 0.001 |
| Secondary outcome | ||||||||
| MV (> 72 h) | 3.21 (2.77, 3.72) | < 0.001 | 2.55 (2.13, 3.05) | < 0.001 | 2.24 (1.78, 2.83) | < 0.001 | 2.85 (2.17, 3.78) | < 0.001 |
| RRT | 5.12 (3.57, 7.15) | < 0.001 | 3.43 (2.19, 5.26) | < 0.001 | 4.47 (2.26, 9.90) | < 0.001 | 6.76 (2.64, 19.62) | < 0.001 |
| Vasopressor use (> 24 h) | 1.59 (1.34, 1.88) | < 0.001 | 1.36 (1.10, 1.67) | 0.004 | 1.21 (0.95, 1.54) | 0.124 | 1.29 (0.95, 1.75) | 0.101 |
| ICU-stays (> 3 days) | 2.40 (2.11, 2.73) | < 0.001 | 1.93 (1.67, 2.24) | < 0.001 | 1.89 (1.58, 2.27) | < 0.001 | 2.23 (1.80, 2.75) | < 0.001 |
| Hospital-stays (> 14 days) | 5.45 (4.79, 6.22) | < 0.001 | 4.44 (3.85, 5.13) | < 0.001 | 4.06 (3.33, 4.95) | < 0.001 | 4.98 (4.00, 6.23) | < 0.001 |
| Outcomes | Original cohort | Matched cohort | ||||||
|---|---|---|---|---|---|---|---|---|
| Non-adjusted | Adjusted | Non-adjusted | Adjusted | |||||
| HR (95% CI) | P value | HR (95% CI) | P value | HR (95% CI) | P value | HR (95% CI) | P value | |
| CI: confidence interval; HR: hazard ratio. | ||||||||
| 90-day mortality | 2.37 (2.04, 2.75) | < 0.001 | 1.44 (1.23, 1.68) | < 0.001 | 1.43 (1.14, 1.79) | 0.002 | 1.43 (1.20, 1.70) | < 0.001 |
| 180-day mortality | 2.22 (1.93, 2.56) | < 0.001 | 1.42 (1.23, 1.64) | < 0.001 | 1.34 (1.09, 1.65) | 0.005 | 1.41 (1.15, 1.74) | < 0.001 |
| 365-day mortality | 2.16 (1.93, 2.43) | < 0.001 | 1.40 (1.25, 1.58) | < 0.001 | 1.36 (1.15, 1.62) | < 0.001 | 1.53 (1.21, 1.92) | < 0.001 |