Combination of low muscle strength and malnutrition is associated with longer length of hospital stay among older patients with heart failure

Abstract

BackgroundMuscle strength and nutritional status are associated with length of hospital stay (LOHS) in older patients with heart failure (HF). ObjectivesThe purpose of the study was to examine the association of the combination of muscle strength and nutritional status on LOHS in older patients with HF. MethodsThis retrospective cohort study included 414 older inpatients with HF (men, 57.2%; median age, 81 years; interquartile range, 75–86 years). Patients were categorized into four groups according to their muscle strength and nutritional status: group 1, high muscle strength and normal nutritional status; group 2, low muscle strength and normal nutritional status; group 3, high muscle strength and malnutrition; and group 4, low muscle strength and malnutrition. The outcome variable was the LOHS, and an LOHS of >16 days was defined as long LOHS. ResultsMultivariate logistic regression analysis adjusted for baseline characteristics (reference, group 1) showed that group 4 was associated with a more significant risk of long LOHS (odds ratio [OR], 3.54 [95% confidence interval, 1.85–6.78]). In the subgroup analysis, this relationship was maintained for the first admission HF group (OR, 4.65 [2.07–10.45]) but not for the HF readmission group (OR, 2.80 [0.72–10.90]). ConclusionsOur results suggest that the long LOHS for older patients with HF at first admission was associated with a combination of low muscle strength and malnutrition but not by either factor individually.