Abstract 19142: Is Malnutrition Associated With Worse Outcomes in Patients With Acute Decompensated Heart Failure (ADHF)? ; Insights From Nationwide Inpatient Sample 2015-2020

Abstract

Introduction: Is Malnutrition associated with worse outcomes in patients admitted with acute decompensated heart failure? Insights from nationwide inpatient sample 2015-2020 Hypothesis: Heart Failure affects >5 million US patients resulting in >1 million annual hospitalizations due to Acute Decompensated Heart Failure (ADHF). The impact of malnutrition on hospitalized patients with ADHF is not well described. Patients with heart failure are prone to malnutrition because of reduced intake, cytokine dysfunction, and increased basal metabolic rate. We aim to assess the effect of malnutrition on hospital outcomes in ADHF. Methods: Using the NIS database we identified all the patients who were admitted for ADHF with history of heart failure with reduced ejection fraction from 2015-2020. Predictors and effects of malnutrition were studied using univariate and multivariate models. Results: A total of 4,224,869 patients were admitted for ADHF from 2015-2020 among which 253,915 patients had associated malnutrition. Baseline characteristics and comorbidities are outlined in the table below. Patients with malnutrition had higher inpatient mortality (9.6% vs 3.61% p-value:0.0000), a longer length of stay (10.8 days vs 5.9 days p-value: 0.0000), doubling of the cost of care (147485 USD vs 74077 USD p-value:0.001). After adjusting for baseline co-morbidities patients with malnutrition had 2 times higher mortality (Odds ratio: 2.01, p-value: 0.0001) Conclusions: Our study demonstrates that Malnutrition in ADHF patients results in higher mortality, longer length of stay, and higher costs of care. This highlights the importance of optimizing of nutritional status in these patients.