Abstract 16225: Protein Energy Malnutrition is Associated With Increased Inpatient Mortality in Patients Admitted for Atrial Fibrillation: Analysis of the National Inpatient Sample
Introduction: Various forms of protein energy malnutrition (PEM) has been shown to affect different heart pathologies through its underlying pathogenesis of unabating chronic inflammation. The effect of PEM on atrial fibrillation (AF) is unclear. Our study sought to estimate the impact of PEM on clinical outcomes of hospitalizations for AF using a national database Methods: We queried the National Inpatient Sample (NIS) 2016 and 2017 database. The NIS is the largest inpatient hospitalization database in the United States. The NIS was searched for hospitalization of adult patients with AF as a principal diagnosis with and without PEM as a secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality while the secondary outcomes were hospital length of stay (LOS) and total hospital charge. STATA software was used for analysis. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. Results: There were over 71 million discharges in the combined 2016 and 2017 NIS database. Out of 821,629 AF hospitalizations, 3% had PEM. Hospitalization for AF with PEM had a statistically significant increase in mortality (5.2% vs 0.8%, AOR 2.33, 95% CI 1.96 - 2.78, P<0.0001), with an adjusted increase in mean hospital charge of $15,862 (95% CI 11,999 - 19,725, P<0.0001) and a 2 day increase in LOS (95% CI 2.00 - 2.50, P= <0.0001) compared to those without PEM. Conclusion: In conclusion, PEM resulted in increased mortality, LOS and total hospital charge in patients hospitalized with AF. Nutritional rehabilitation in patients with PEM and concomittant AF may be needed to improve outcomes.