Abstract 13638: Protein Calorie Malnutrition is an Adverse Prognostic Marker in Atrial Fibrillation Patients: An Analysis of the National Inpatient Sample Registry

Abstract

Introduction: Protein Calorie Malnutrition (PCM) is not thought to be associated with atrial fibrillation (AF). Some research has stipulated that overweight AF patients may have a better prognosis than those with normal weight, however, the interaction between poor nutritional status and AF has not been well explored. Dyselectrolytemias secondary to malnutrition could confer a poor prognosis in AF patients. We aimed to assess the impact of PCM on outcomes in patients admitted with AF. Methods: A retrospective cohort study was conducted using the Nationwide Inpatient Sample from 2017. About 412,159 hospitalizations who had AF as their primary diagnosis were identified and stratified based on the presence of PCM using ICD-10 codes. Multivariate regression analysis was used to adjust for confounders and to analyze the variables. The selection of covariates was done with a univariate screen and literature review. Results: Out of the 412,159 hospitalized patients with AF, 11,590 individuals had PCM. In-hospital mortality in AF patients with PCM were significantly higher than those without (4.62% vs 0.77%); p<0.0001. When adjusted for patient demographics, comorbidities, and hospital characteristics, AF patients with PCM had a higher risk of mortality (aOR=3.45, p<0.0001), cardiac arrest (aOR=2.41, p<0.0001), PE (aOR=2.06, p<0.0001), sepsis (aOR=4.72, p<0.0001), pneumonia (aOR=2.25, p<0.0001), AKI (aOR=1.41, p<0.0001), acute respiratory failure (ARF) (aOR=1.81, p=0.011), and being intubated (aOR=1.45, p=0.019). When adjusted similarly, AF patients with PCM had longer length of stay (LOS) by 2.76 days (mean LOS: 6.61 vs 3.25 days) (p<0.0001) and an additional hospital cost (HC) of $18,373 (mean HC: $62,093 vs $39,934) (p<0.0001). However, there was no difference in the risk of developing stroke (aOR=1.23, p=0.26) in AF patients with PCM. Conclusions: AF patients with PCM had worse outcomes in terms of in-hospital mortality, LOS, HC, cardiac arrest, PE, sepsis, pneumonia, AKI, ARF, and being intubated compared to those without PCM. This suggests that PCM is an adverse prognostic marker in this population. Current limitations include the underrepresentation of metabolic derangements due to inadequate coding within this administrative database.