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

↓  Figure 1. Flow diagram for data inclusion in the present study.
Figure 1.
↓  Figure 2. Plot of standardized mean difference after propensity score analysis. IPTW: inverse probability of treatment weighting; SMRW: standardized mortality ratio weighting; PSMW: propensity score matching weighting; OW: overlap weighting.
Figure 2.
↓  Figure 3. Kaplan-Meier curves for 365-day survival probability comparing two groups. (a) Before matched. (b) After matched. (c) Propensity score matching weighting (PSMW). (d) Inverse probability weighting (IPWT). The red line represents patients without weight loss and the blue line represents patients with combined weight loss.
Figure 3.
↓  Figure 4. The forest plot of logistic and Cox regression analysis for 365-day mortality. PSMW: propensity score matching weighting; IPTW: inverse probability of treatment weighting; SMRW: standardized mortality ratio weighting; OW: overlap weighting.
Figure 4.

Tables

↓  Table 1. Comparisons of Characteristics Between the Original Cohort and Matched Cohort
 
CharacteristicOriginal cohortMatched cohort
Group 1 (n = 28,258)Group 2 (n = 959)SMDGroup 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)0.04724 (75.7)706 (73.8)0.044
  Age65.20 (52.22, 77.38)66.55 (53.79, 78.27)0.09568.09 (54.95, 79.59)66.55 (53.81, 78.28)0.058
  Ethnicity, n (%)0.0940.044
    White20,415 (72.2)707 (73.7)724 (75.7)706 (73.8)
    Black2,095 (7.4)87 (9.1)79 (8.3)87 (9.1)
    Other5,748 (20.3)165 (17.2)154 (16.1)164 (17.1)
  Admission, n (%)0.3820.054
    Elective4,815 (17.0)52 (5.4)41 (4.3)52 (5.4)
    Emergency22,711 (80.4)890 (92.8)900 (94.0)888 (92.8)
    Urgent732 (2.6)17 (1.8)16 (1.7)17 (1.8)
Weight, kg79.00 (67.00, 93.00)69.00 (58.00, 83.00)0.42577.00 (65.00, 91.00)69.00 (58.00, 83.00)0.380
Vital signs
  Heart rate, bpm83.39 (73.92, 93.75)86.84 (76.82, 99.18)0.26587.06 (76.45, 98.84)86.80 (76.82, 99.00)0.033
  Respiratory rate, bpm17.78 (15.81, 20.28)18.48 (16.30, 21.55)0.18518.54 (16.32, 21.38)18.48 (16.30, 21.54)< 0.001
  Temperature, °C36.82 (36.49, 37.20)36.80 (36.44, 37.23)0.01536.81 (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)0.02297.69 (96.44, 98.80)97.75 (96.33, 99.00)0.022
  SBP, mm Hg117.35 (108.04, 129.40)115.64 (105.72, 131.16)0.041116.86 (107.63, 129.71)115.64 (105.72, 131.17)0.049
  DBP, mm Hg60.08 (54.00, 67.15)60.35 (53.62, 67.89)0.06460.56 (54.85, 68.00)60.42 (53.61, 67.91)0.022
  MAP, mm Hg77.23 (71.25, 84.76)76.67 (69.68, 85.33)0.02677.06 (71.00, 85.44)76.75 (69.71, 85.34)0.04
Severity of illness
  GCS15.00 (14.00, 15.00)15.00 (13.00, 15.00)0.18415.00 (13.00, 15.00)15.00 (13.00, 15.00)0.046
  SOFA3.00 (2.00, 5.00)4.00 (2.00, 7.00)0.324.00 (2.00, 6.00)4.00 (2.00, 7.00)< 0.001
  OASIS30.00 (25.00, 36.00)33.00 (28.00, 39.00)0.38234.00 (28.00, 39.00)33.00 (28.00, 39.00)0.006
Comorbidities, n (%)
  CHF6,544 (23.2)245 (25.5)0.056243 (25.4)244 (25.5)0.002
  Hypertension15,567 (55.1)448 (46.7)0.168456 (47.6)448 (46.8)0.017
  Stroke971 (3.4)80 (8.3)0.2177 (8.0)79 (8.3)0.008
  COPD4,861 (17.2)196 (20.4)0.083182 (19.0)195 (20.4)0.034
  Diabetes mellitus7,187 (25.4)229 (23.9)0.036224 (23.4)229 (23.9)0.012
  Renal failure3,409 (12.1)156 (16.3)0.121165 (17.2)156 (16.3)0.025
  Liver disease1,698 (6.0)141 (14.7)0.288135 (14.1)141 (14.7)0.018
  Malignancy2,317 (8.2)128 (13.3)0.167113 (11.8)126 (13.2)0.041
  Coagulopathy2,636 (9.3)182 (19.0)0.28165 (17.2)181 (18.9)0.043
Laboratory tests
  WBC, × 109/L12.30 (9.10, 16.30)12.50 (8.80, 17.35)0.03112.50 (9.10, 16.90)12.50 (8.80, 17.30)0.028
  Hemoglobin, g/dL10.10 (8.60, 11.80)9.60 (8.40, 11.00)0.219.70 (8.30, 11.30)9.60 (8.40, 11.00)0.012
  Platelet, × 109/L186.00 (134.00, 247.00)201.00 (129.00, 282.00)0.175196.00 (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)0.16428.80 (24.70, 33.30)28.50 (24.80, 32.60)0.01
  INR1.30 (1.10, 1.50)1.30 (1.20, 1.70)0.1221.30 (1.10, 1.70)1.30 (1.20, 1.70)0.042
  PT, s14.30 (13.10, 16.10)14.70 (13.20, 17.85)0.16614.70 (13.30, 17.50)14.70 (13.20, 17.80)0.026
  PTT, s31.40 (26.80, 41.50)32.80 (28.00, 43.20)0.05132.50 (27.00, 44.60)32.70 (28.00, 43.20)0.003
  Bun, mg/dL19.00 (14.00, 28.00)22.00 (14.00, 37.00)0.20522.00 (15.00, 35.00)22.00 (14.00, 37.00)0.005
  Creatinine, mg/dL1.00 (0.80, 1.30)1.00 (0.70, 1.50)0.0641.10 (0.80, 1.50)1.00 (0.70, 1.50)0.011
  Potassium, mmol/L4.50 (4.10, 5.10)4.30 (4.00, 4.80)0.2184.30 (4.00, 4.90)4.30 (4.00, 4.80)0.013
  Sodium, mmol/L140.00 (138.00, 142.00)140.00 (137.00, 143.00)0.009141.00 (138.00, 143.00)140.00 (137.00, 143.00)0.072
  Bicarbonate, mmol/L25.00 (23.00, 27.00)25.00 (22.00, 28.00)0.01625.00 (23.00, 27.00)25.00 (22.00, 28.00)0.018
  Chloride, mmol/L107.00 (104.00, 111.00)107.00 (103.00, 111.00)0.005108.00 (104.00, 111.00)107.00 (103.00, 111.00)0.068
  Glucose, mEq/L156.00 (125.00, 194.75)150.00 (120.00, 196.50)0.015154.00 (125.00, 199.00)150.00 (120.00, 197.00)0.04
  Anion gap, mmol/L14.00 (12.00, 17.00)15.00 (13.00, 18.00)0.14715.00 (13.00, 18.00)15.00 (13.00, 18.00)0.063

 

↓  Table 2. Clinical Outcomes Analysis on the Original Cohort and Matched Cohort
 
OutcomesOriginal cohortMatched cohort
TotalGroup 1Group 2P valueTotalGroup 1Group 2P 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 mortality2,577 (8.8)2,395 (8.5)182 (19.0)< 0.001311 (16.2)130 (13.6)181 (18.9)0.002
  180-day mortality3,209 (11.0)3,000 (10.6)209 (21.8)< 0.001371 (19.4)162 (16.9)209 (21.8)0.008
  365-day mortality4,854 (16.6)4,553 (16.1)301 (31.4)< 0.001532 (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)< 0.001315 (16.5)145 (15.2)170 (17.8)0.139
  RRT271 (0.9)232 (0.8)39 (4.1)< 0.00148 (2.5)9 (0.9)39 (4.1)< 0.001
  MV (> 72 h)3,176 (10.9)2,917 (10.3)259 (27.0)< 0.001395 (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)< 0.001911 (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)< 0.001732 (38.2)215 (22.5)517 (54.0)< 0.001

 

↓  Table 3. Logistic Regression Analysis of Clinical Outcomes on the Original Cohort and Matched Cohort
 
OutcomesOriginal cohortMatched cohort
Non-adjustedAdjustedNon-adjustedAdjusted
OR (95% CI)P valueOR (95% CI)P valueOR (95% CI)P valueOR (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 mortality2.53 (2.14, 2.98)< 0.0011.59 (1.32, 1.91)< 0.0011.48 (1.16, 1.90)0.0021.65 (1.26, 2.17)< 0.001
  180-day mortality2.35 (2.00, 2.74)< 0.0011.53 (1.28, 1.82)< 0.0011.37 (1.09, 1.72)0.0071.49 (1.16, 1.93)0.002
  365-day mortality2.38 (2.07, 2.74)< 0.0011.57 (1.34, 1.84)< 0.0011.43 (1.17, 1.75)0.0011.56 (1.25, 1.96)< 0.001
Secondary outcome
  MV (> 72 h)3.21 (2.77, 3.72)< 0.0012.55 (2.13, 3.05)< 0.0012.24 (1.78, 2.83)< 0.0012.85 (2.17, 3.78)< 0.001
  RRT5.12 (3.57, 7.15)< 0.0013.43 (2.19, 5.26)< 0.0014.47 (2.26, 9.90)< 0.0016.76 (2.64, 19.62)< 0.001
  Vasopressor use (> 24 h)1.59 (1.34, 1.88)< 0.0011.36 (1.10, 1.67)0.0041.21 (0.95, 1.54)0.1241.29 (0.95, 1.75)0.101
  ICU-stays (> 3 days)2.40 (2.11, 2.73)< 0.0011.93 (1.67, 2.24)< 0.0011.89 (1.58, 2.27)< 0.0012.23 (1.80, 2.75)< 0.001
  Hospital-stays (> 14 days)5.45 (4.79, 6.22)< 0.0014.44 (3.85, 5.13)< 0.0014.06 (3.33, 4.95)< 0.0014.98 (4.00, 6.23)< 0.001

 

↓  Table 4. Cox Regression Analysis of Clinical Outcomes on the Original Cohort and Matched Cohort
 
OutcomesOriginal cohortMatched cohort
Non-adjustedAdjustedNon-adjustedAdjusted
HR (95% CI)P valueHR (95% CI)P valueHR (95% CI)P valueHR (95% CI)P value
CI: confidence interval; HR: hazard ratio.
90-day mortality2.37 (2.04, 2.75)< 0.0011.44 (1.23, 1.68)< 0.0011.43 (1.14, 1.79)0.0021.43 (1.20, 1.70)< 0.001
180-day mortality2.22 (1.93, 2.56)< 0.0011.42 (1.23, 1.64)< 0.0011.34 (1.09, 1.65)0.0051.41 (1.15, 1.74)< 0.001
365-day mortality2.16 (1.93, 2.43)< 0.0011.40 (1.25, 1.58)< 0.0011.36 (1.15, 1.62)< 0.0011.53 (1.21, 1.92)< 0.001