Body Composition, Critical Illness, Mortality in Intensive Care Units, Obesity & Overweight
Conditions
Keywords
Body Roundness Index, BRI, ICU mortality, Critical illness, Anthropometric measures, Central adiposity, BMI, Obesity paradox, Waist circumference
Brief summary
This study investigates whether Body Roundness Index (BRI), an anthropometric measure derived from waist circumference and height, can predict mortality in adult intensive care unit (ICU) patients. BRI captures central adiposity and body fat distribution more accurately than Body Mass Index (BMI). In this prospective multicenter cohort study, BRI will be measured at ICU admission and its association with ICU mortality, 28-day mortality, hospital mortality, mechanical ventilation duration, ICU length of stay, and acute kidney injury will be evaluated. The predictive performance of BRI will also be compared with BMI.
Detailed description
Body Roundness Index (BRI) is calculated using waist circumference and height, and reflects central adiposity more precisely than BMI. Despite growing evidence supporting BRI as a cardiovascular and metabolic risk predictor in general populations, its prognostic value in critically ill patients remains unexplored. In this prospective multicenter cohort study, adult patients admitted to participating ICUs will be enrolled. Waist circumference will be measured using a standardized protocol (supine position, iliac crest landmark, end-expiration, inelastic tape, 0.1 cm precision) within 24 hours of ICU admission. BRI will be calculated using the formula: 364.2 - 365.5 × √(1 - ((WC/2π)² / (0.5×height)²)). The primary outcome is ICU mortality. Secondary outcomes include 28-day mortality, hospital mortality, mechanical ventilation duration, ICU length of stay, and new acute kidney injury (KDIGO stage ≥2). The shape of the BRI-mortality relationship will be assessed using restricted cubic splines. BRI and BMI will be compared head-to-head for discriminative performance. Subgroup analyses will include sepsis patients to evaluate whether BRI resolves the obesity paradox observed with BMI.
Interventions
None listed
Sponsors
Ondokuz Mayıs University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥18 years * ICU admission with expected stay ≥24 hours * Waist circumference and height measurable within 24 hours of admission
Exclusion criteria
* Age \<18 years * ICU stay \<24 hours * Missing or unmeasurable anthropometric data (e.g., severe edema, abdominal wound, morbid obesity precluding measurement) * Pregnancy * Readmission (only first ICU admission included)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| ICU Mortality | From ICU admission to ICU discharge or death, up to 28 days. | Death occurring during ICU stay, assessed from admission to ICU discharge or death, whichever comes first. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 28-Day Mortality | 28 days from ICU admission. | All-cause mortality within 28 days of ICU admission. |
| Hospital Mortality | From ICU admission to hospital discharge or death, up to 90 days. | Death occurring during hospital stay |
| Mechanical Ventilation Duration | From ICU admission to ICU discharge, up to 28 days. | Total days of invasive mechanical ventilation during ICU stay. |
| ICU Length of Stay | From ICU admission to ICU discharge, up to 28 days. | Total number of days spent in the ICU |
| Number of Participants with New Acute Kidney Injury (KDIGO Stage ≥2) | From ICU admission to ICU discharge, up to 28 days. | New AKI development defined as KDIGO stage ≥2 during ICU stay. |
Countries
Turkey (Türkiye)
Contacts
CONTACTÖzkul Yilmaz Çolak, MD
Outcome results
None listed