Abstract #1175969: Protein Energy Malnutrition Strongly Predicts Adverse Outcomes Across Different Hospitalizations

Abstract

Protein Energy Malnutrition (PEM) is a common medical problem in hospitalized patients. In this study we aim to analyze the prevalence and impact of PEM diagnosis during 2019 hospitalizations. A retrospective study of 2019 data from the inpatient national sample (NIH) was performed. We identified all hospitalizations with PEM diagnosis using ICD 10 codes (International Classification of Diseases, Tenth Revision, Clinical Modification). We queried the 2019 National Inpatient Sample for primary diagnoses of either Sepsis or Pneumonia. Prevalence and predictors of mortality were noted in this cohort, using a multivariable-adjusted model to age, gender, Charlson Comorbidity Index, other comorbidities (Hyperlipidemia, Atrial fibrillation, History of stroke, Hypertension, Obstructive Sleep apnea history), hospitals region, socioeconomic status, insurance status and hospital size. We identified 1,856,025 adult hospitalizations with PEM as a secondary diagnosis (6.1% of the total adult hospitalizations in 2019), 50.6% female, mean age 67.6 years old, 9.9% of these hospitalizations for pneumonia and 17.6% for sepsis as primary diagnosis on discharge. Patients with PEM secondary diagnosis had higher odds for mortality in hospitalized adult patients (adjusted OR 2.11 (95% CI 2.06-2.17; p< 0.001), higher odds for pneumonia hospitalizations (adjusted OR 1.59 (95% CI 1.51-1.66; p< 0.001), higher odds for sepsis hospitalizations (adjusted OR 2.31 (95% CI 2.26 to 2.36; p< 0.001) compared to patients without PEM. PEM is associated with an increase in the mean length of stay by 4.2 days (95% CI 4.16 to 4.43; p< 0.001). Our analysis showed a large number of hospitalized adults with PEM, and is associated with poor outcomes for hospitalized patients with increased risk of in-hospital mortality, and increased length of in-hospital stay. Furthermore it is strongly associated with sepsis and pneumonia hospitalizations pointing to the importance of addressing this disease in hospitalized patients.