Malnutrition Severity is Associated with Worse Outcomes in Advanced Heart Failure Recipients.

Malnutrition has been associated with inferior outcomes in patients with advanced heart failure (HF) therapy, which includes heart transplantation and Left Ventricular Assist Device implantation (LVAD). However, there is a lack of data to assess if the degree of malnutrition correlates with outcome severity. Our cross-sectional study used Nationwide Readmission Database (NRD) for 2016-2019. First, we extracted all cases older than 18 years that received advanced heart failure therapy during the index admission. Appropriate survey and domain analyses were applied to obtain national estimates using SAS 9.4. We identified 27,409 discharges who received advanced HF therapy. Malnutrition was present in 27% of the study cohort (n=7,443 cases). Most malnourished patients (81%, n=6,034) had moderate-severe malnutrition. Patients with malnutrition were slightly older than those without malnutrition (mean age 56 years vs. 54 years, p<0.001) and had fewer women (22% vs. 24%, p<0.001). Univariate analysis showed that moderate-severe malnutrition is associated with higher inpatient mortality compared to no malnutrition (OR 2.36[2.04-2.72], p<0.001). Mild malnutrition was not associated with higher inpatient mortality (OR 1.04[0.75-1.44]). After adjusting for age, gender, cerebrovascular disease, acute encephalopathy, acute myocardial infarction, peptic ulcer disease, coagulopathy, peripheral vascular disease, as well as chronic kidney and liver diseases, the presence of moderate-severe malnutrition continued to be associated with higher inpatient mortality compared to those without malnutrition (aOR 1.74[1.48-2.05], p<0.001). Either degree of malnutrition was associated with higher 30-day readmission (aOR 1.16[1.06-1.27], p<0.001) and length of stay (mean of 56 days in moderate-severe malnutrition vs. mean of 52 days in mild malnutrition vs. mean of 33 days with no malnutrition, p<0.001). In patients receiving advanced HF therapy, malnutrition severity correlates with worse outcomes. [ABSTRACT FROM AUTHOR]