PROTEIN-ENERGY MALNUTRITION IS ASSOCIATED WITH HIGHER MORTALITY AND ADVERSE CLINICAL OUTCOMES IN PATIENTS WITH COPD WITH CO-EXISTING ATRIAL FIBRILLATION

Abstract

TYPE: Abstract TOPIC: Obstructive Lung Diseases PURPOSE: Poor nutritional status worsens clinical outcomes in those afflicted by cardiopulmonary disease. Protein-Energy Malnutrition (PEM) worsens outcomes for patients with chronic obstructive pulmonary disease(COPD). The impact of PEM on COPD with co-existing atrial fibrillation (COPD-AF) is not well known. Therefore, our study sought to measure the effect of PEM on clinical outcomes in patients with COPD & co-existing AF (COPD-AF). METHODS: We queried the National Inpatient Sample (NIS) between 2017 & 2018. We searched the NIS for adult patients hospitalized with COPD with co-existing AF (COPD-AF) as a principal diagnosis with & without PEM as a secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality, while secondary outcomes were cardiac arrest (CA), cardiogenic shock (CS), respiratory failure (RF), length of stay (LOS), & total hospital charge (THC). A multivariable logistic and Poisson regression analysis was applied for clinical outcomes. RESULTS: A total of 170,355 patients with COPD-AF were admitted, & 5% had PEM. PEM vs No PEM cohorts include;(Mean Age 75.6 years[CI 75.1-76] vs 73.7 years[CI 73.5-73.8]), Males (45% vs 48.6%), Whites(83.8% vs 81.9%), Black(8% vs 10%), & Hispanic(4.2% vs 4.8%). PEM in patients hospitalized with COPD-AF had a significant increase in inpatient mortality(p<0.0001), RF (p<0.0001), Intubation(p<0.0001) and CS (p=0.025)(Table 1). PEM also resulted in higher THC $73,876 vs $40,351(p<0.0001) & Longer LOS 7.2 vs 4.6 days (p<0.0001),(Table 1). CONCLUSIONS: PEM raised the risk of adverse clinical outcomes & hospital expense in patients hospitalized with COPD & Co-Existing AF. CLINICAL IMPLICATIONS: Clinicians should be aware of the increased inpatient mortality in COPD-AF with Co-existing PEM. DISCLOSURE: Nothing to declare. KEYWORD: PROTEIN-ENERGY MALNUTRITION, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, ATRIAL FIBRILLATION.