Abstract 11433: Protein-Energy Malnutrition is Associated with Higher Mortality and Adverse Clinical Outcomes in Patients with Systolic Heart Failure with History of Atrial Fibrillation

Abstract

Introduction: Poor nutritional status worsens clinical outcomes in multiple disease states. Protein-Energy Malnutrition (PEM) worsens outcomes for patients with systolic heart failure (SysHF). Similarly, Atrial Fibrillation (AF) worsens outcomes of SysHF. The impact of PEM on patients with SysHF & AF is not known. Therefore, our study sought to measure the effect of PEM on clinical outcomes in patients with SysHF & AF. Methods: We queried the National Inpatient Sample (NIS) between 2016 & 2017. NIS was searched for adult patients hospitalized with SysHF with a history of AF as a principal diagnosis with & without PEM as a secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality, while secondary outcomes were the length of stay (LOS), total hospital charge, cardiac arrest, cardiogenic shock, & respiratory failure. A multivariable logistic & linear regression analysis was applied to estimate the odds for the clinical outcome. A p-value <0.05 was considered significant. Results: There were 270,580 SysHF with history of AF admissions, approximately 5.4% (14,611) had PEM. PEM vs No PEM cohorts include; (Mean Age of 77 vs 75 years], Males [57.8% vs 60.9%], Whites [76.5% vs 76.4%], Black [11.8% vs 13%]. PEM resulted in increased LOS (10 days vs 5.4 days, Adjusted LOS 3.6 days [3.1-4.3, P = <0.0001], Increase in hospital charge (PEM $117,969 vs No PEM $50,050, Adjusted charge $59,322 [$46,633-$72,012, P = <0.0001]. Conclusion: In conclusion, PEM raised the risk of adverse clinical outcomes & increased hospital expense in patients hospitalized with SysHF & AF. Assessing nutritional status will aid in risk assessment & help guide cardiovascular treatment. Whether treating protein malnutrition will improve cardiovascular outcomes is unknown.