Abstract 10412: Malnutrition Severity is Associated With Worse Outcomes in Patients Admitted With Acute Myocardial Infarction

Abstract

Introduction: Malnutrition has been associated with inferior outcomes in patients admitted with acute myocardial infarction (AMI). However, there is a lack of data to assess if the degree of malnutrition correlates with outcome severity. Methods: We used Nationwide Readmission Database (NRD) for 2016-2019 in our cross-sectional study. First, we extracted all cases older than 18-years that include a primary diagnosis of AMI. Appropriate survey and domain analyses were applied to obtain national estimates using SAS 9.4. Results: We identified 2,280,393 discharges for AMI. Malnutrition was present in 4% of the study cohort (or 89,490 cases). Half of the patients with malnutrition (or 44,919) had moderate to severe malnutrition. The other 44,371 (or 50%) had a milder degree of malnutrition. Patients with malnutrition were younger than those without malnutrition (mean age 72-years vs. 75-years, p<0.001) and had more women (48% vs. 37%, p<0.001). Patients with malnutrition had a higher prevalence of underlying heart failure, dementia, coagulopathy, and chronic (liver, renal, and lung) diseases (p<0.001). Malnourished patients also had significantly higher inpatient mortality (12.5% vs. 4.6%, p<0.001), length of stay (mean of 13 days vs. 7 days, p<0.001), and all-cause 30-day readmission rates (19% vs. 13%, p<0.001). Inpatient mortality on readmission was also higher in those with malnutrition (2% vs. 0.6%, p<0.001). Univariate analysis showed that the severity of malnutrition also correlated with higher inpatient mortality (OR 2.34[2.24-2.46] for mild malnutrition and 3.65[3.49-3.82] for advanced malnutrition). After adjusting for age, gender, heart failure, dementia, coagulopathy, chronic (liver, renal, and lung) diseases, and history of cardiovascular revascularization presence of malnutrition and severity of malnutrition continued to be associated with higher inpatient mortality compared to those without malnutrition (OR 1.20[1.14-1.26] for mild malnutrition and OR 1.69[1.61-1.78] for more severe malnutrition). Conclusions: In patients hospitalized with AMI, underlying malnutrition is associated with worse outcomes. The severity of malnutrition also correlates with worse outcomes.