Patients in intensive care are more likely to die in hospital if they are short.
Tall people have much better survival rates when they are very ill, a study of more than 400,000 British patients found.
Around one in five very tall men die in intensive care, but that leaps to 29.2 per cent of the shortest men. Women see their death rates jump from 17.1 to 24.1 per cent if they are smaller.
Experts say shorter people may be at risk because a lot of intensive care equipment is set up for average-sized male patients.
This could see smaller people given too large a dose of medication, such as sedatives, which could lead to sleepiness and ultimately cause them to stop breathing.
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The wrong sized breathing tube could cause damage to the vocal cords in shorter people, the research found.
Dr Hannah Wunsch, who led the study into 210 intensive care units in the UK, said: 'There is no one thing which could explain this increase in mortality in shorter people admitted to intensive care.
'There are so many aspects to how people are looked after which could contribute but together all these small things may have a large impact.'
The researcher, from the Department of Critical Care Medicine at Sunnybrook Hospital in Canada, added: 'The message from this research is for doctors to be more aware of people's height.'
Most people in intensive care tend to have medical complications such as sepsis and heart failure, although the unit also has a smaller proportion of accident and car crash victims.
Researchers looked at death rates for patients from 2009 to 2015 based on their height.
The results, published in the journal Intensive Care Medicine, show that among men of around 6ft 5ins (200cm), 21 per cent will die. That rises to 29.2 per cent for the shortest men, who are just over 4ft 5ins (140cm) tall.
For women of the same heights the death rate goes from 17.1 to 24.1 per cent.
The average-height man's odds of dying are just over 22 per cent, but that death risk increases by around 30 per cent for the very shortest.
Part of the reason may be shorter people's medical histories, as vulnerable people who had cancer in childhood may have been made smaller by chemotherapy. But the death rates are higher for shorter people even when their age and the severity of their illness are taken into account.
Researchers warn that smaller people may inadvertently be overdosed with drugs, as they do not need as much medication as those of average height.
A central line put into their vein to deliver drugs can cause a heart flutter if it is too long, which in rare cases can be fatal.
A ventilator not adjusted for someone's height can damage their lungs as they are forced to take larger breaths than necessary.
Dr Wunsch said: 'We know doctors do not always measure people's heights but equipment settings should often take this into account. The small differences relevant to how tall someone is can add up.'