The Effect of Malnutrition on Outcomes in Patients with Heart-Failure: A Retrospective Cohort Pilot Study

Abstract

Abstract Objectives Current retrospective studies on incidence rates for malnutrition, heart failure, and outcomes are limited in that they do not control for confounding factors, and are relatively small. We undertook a retrospective cohort study to elucidate the association between malnutrition and hospital length-of-stay (LOS), mortality and discharge destination in inpatients with heart failure. Methods Data was obtained from the electronic patient medical records (EMR) for inpatients at Columbia University Irving Medical Center admitted with primary diagnosis of heart failure between January 1st 2018 to December 31st 2018. A two-sided t-test was conducted between two groups of heart failure patients with and without malnutrition on outcomes of mortality, LOS and discharge destination. Results For N = 5598 inpatients, the median age is 74 years old, with 2567 females (45.86%) and 3031 males (54.14%). Overall mortality rate was 6.25% with 350 heart failure deceased patients. After being discharged, there were 2037 (36.39%) patients went home directly and 3211 (57.36%) patients went to some kind of rehabilitation institutions. There was a significant association in mortality in heart failure with malnutrition compared to those without malnutrition (13.98% vs 4.61%, relative risk (RR): 2.4368, P < 0.001). There was a significant association for LOS in heart failure with malnutrition, compared to those without malnutrition (11 days vs 5 days, RR: 2.2, P < 0.001). There was a significant association for discharge destination in heart failure with malnutrition, compared to those without malnutrition (18.27% home vs 42.75% home, RR: 1.43, P < 0.001). Conclusions Patients with heart failure and malnutrition are at higher risk for mortality, increased LOS at the hospital and increase chance of discharging to a rehabilitation institution. Continued study of this population will include the impact of confounders such as socioeconomic status and comorbid conditions, and additional outcomes such as repeated hospitalizations. Funding Sources None.