The relationship between body mass index and mortality in patients with acute decompensated heart failure.

Recent studies have suggested that body mass index (BMI) may be an independent prognostic factor in patients with chronic heart failure (HF). It is unknown whether or not BMI has the same predictive value in acute decompensated heart failure. We studied 489 patients with the previous diagnosis of HF (84% NYHA class III-IV) who were admitted for decompensated HF. During follow-up of greater than 6 months, 110 patients (22.4%) died. Kaplan-Meier analysis demonstrated that patients with BMI <25 kg/m(2) were at a higher risk of death. After adjusting for other risk variables in a Cox proportional hazard regression model, BMI <25 kg/m(2) remained an independent predictor of mortality with a hazard ratio of 1.6 (95% CI 1.1-2.4, p=0.03). We conclude that BMI in the normal or cachectic range is an independent predictor of mortality in patients with acute decompensated HF.