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Weight variability at pediatric intensive care unit admission and adverse outcomes in critically ill children

Jae Hwa Jung1, Yoon Hee Kim2, Min Jung Kim3

  • 1Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Acute and Critical Care
|December 11, 2025
PubMed

Insights

Acute body weight variability in critically ill children is linked to worse outcomes. Higher weight variability at pediatric intensive care unit admission predicts increased mortality and fewer ventilator-free days.

Area of Science:

  • Pediatric critical care medicine
  • Clinical outcomes research
  • Patient monitoring

Background:

  • Body weight fluctuates in critically ill children due to fluid shifts, nutrition, illness type, and comorbidities.
  • Acute body weight variability (WV) is a potential indicator of clinical status.
  • Understanding WV's impact is crucial for pediatric intensive care unit (PICU) management.

Purpose of the Study:

  • To investigate the association between acute body weight variability (WV) and clinical outcomes in critically ill pediatric patients.
  • To determine if WV can enhance existing mortality prediction models.

Main Methods:

  • Retrospective analysis of 926 pediatric patients (1 month to 18 years) admitted to a PICU.
  • WV defined as percentage difference between admission weight and usual body weight.
  • Association of WV with PICU mortality and ventilator-free days (VFDs) assessed.

Main Results:

  • Median WV was significantly higher in non-survivors (8.7%) versus survivors (0.0%).
  • Increased WV independently predicted higher mortality (HR, 1.102) and fewer VFDs (OR, 0.599).
  • WV combined with the Pediatric Index of Mortality 3 score improved mortality prediction (AUC, 0.888).

Conclusions:

  • Higher body weight variability at PICU admission is independently associated with adverse outcomes.
  • WV may serve as a valuable tool to complement existing pediatric critical care mortality prediction models.
Abstract

Keywords:
critical illnessmortalitypediatric intensive care unitprognosisweight variability

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