Abstract 13747: Undernutrition Severity Correlates With Worse Outcomes in Patients Admitted With Peripheral Artery Disease

Abstract

Introduction: Malnutrition has been associated with inferior outcomes in general. However, there is a lack of data to assess if the degree of malnutrition correlates with worse outcomes in patients with peripheral artery disease (PAD). Methods: We used Nationwide Readmission Database (NRD) for 2016-2019 in our study. First, we extracted all cases older than 18 years that include a primary diagnosis of PAD. Appropriate survey and domain analyses were applied to obtain national estimates using SAS 9.4. Results: We identified 599,717 discharges with PAD. Malnutrition was present in 8% of the study cohort (or 49,853 cases). Half of the patients with malnutrition (or 26,090) had moderate to severe malnutrition. Malnourished patients had similar age distribution compared to those without malnutrition (mean age 71 years vs. 72 years) and slightly more women (42% vs. 37%, p<0.001). Patients with malnutrition had a higher prevalence of underlying heart failure, dementia, coagulopathy, malignancy, and chronic (liver, renal, and lung) diseases (p<0.001), but similar frequency of hypertension and diabetes. They also had significantly higher inpatient mortality (6% vs. 1.4%, p<0.001), length of stay (mean of 15 days vs. 11 days, p<0.001), and all-cause 30-day readmission rates (27% vs. 22%, p<0.001). Inpatient mortality on readmission was also higher in those with malnutrition (9% vs. 3.8%, p<0.001). Univariate analysis showed that the severity of malnutrition also correlated with higher inpatient mortality (OR 3.8[3.4-4.2] for mild malnutrition and 5[4.6-5.5] for advanced malnutrition). Figure 1 shows that malnutrition is associated with higher inpatient mortality even after adjustment for significant comorbidities and vascular interventions. Conclusions: In patients hospitalized with PAD, underlying malnutrition is an adverse prognosticator.